PMID- 29122081
OWN - NLM
STAT- MEDLINE
DCOM- 20180808
LR  - 20180808
IS  - 1945-8932 (Electronic)
IS  - 1945-8932 (Linking)
VI  - 31
IP  - 6
DP  - 2017 Nov 1
TI  - Gender-specific differences in serum immunoglobulin E levels and prevalence of 
      fungus in sinonasal tissue noted in patients with chronic rhinosinusitis who 
      underwent endoscopic sinus surgery.
PG  - 370-375
LID - 10.2500/ajra.2017.31.4471 [doi]
AB  - BACKGROUND: We previously presented that women with chronic rhinosinusitis (CRS) 
      who elected endoscopic sinus surgery (ESS) have a higher symptom burden than men. 
      Causes of these gender-based differences warranted further study. OBJECTIVES: To 
      study gender differences in another cohort of adult patients with CRS who 
      underwent ESS and to compare key histopathologic and serologic features Methods: 
      Patients with CRS who underwent ESS (from 2011 to 2014) with structured 
      histopathology reports on surgical samples were studied. The 13-item structured 
      histopathology report detailed key metrics of inflammation and the presence of 
      fungal elements. Clinical, 22-item Sino-Nasal Outcome Test (SNOT-22) score, 
      Lund-Mackay computed tomography (CT) score, serologic (immunoglobulin E [IgE] 
      level, absolute eosinophil count) and histopathologic data were compared between 
      male and female patients by using statistical software. RESULTS: We studied 130 
      eligible subjects (mean age, 54.7 years; 49.2% women). Compared with the men, the 
      women had significantly higher preoperative SNOT-22 scores (women, 48.7; men 38.0 
      [p = 0.004]) but similar CT scores. Serum IgE levels were significantly higher 
      among women versus men (peak, 433.3 versus 190.8 kU/L [p = 0.03]; closest to 
      surgery, 435.0 versus 190.8 kU/L [p = 0.03]). Tissue fungal elements were 
      significantly more prevalent in women versus men (19.0 versus 5.2%; p = 0.02). Up 
      to this point, the analysis was agnostic of clinical details of the subjects. 
      Further analysis was conducted regarding clinical features. Allergic fungal 
      sinusitis (AFS) was found significantly more commonly in the female versus male 
      patients (21.9 versus 9.1%; p = 0.04). Women versus men had a higher prevalence 
      of migraine (19.4 versus 4.6%; p = 0.01) or any primary headache disorders (23.0 
      versus 6.2%; p = 0.007). CONCLUSION: Women who underwent ESS for CRS had higher 
      SNOT-22 symptom burden. Worsened symptomatology may be secondary to a higher 
      prevalence of primary headache disorders in women. However, surgeons should also 
      be aware that female patients with CRS who seek ESS may have a higher prevalence 
      of severe disease endotypes (more tissue fungal elements, elevated serum IgE 
      levels) and phenotypes.
FAU - Azar, Antoine
AU  - Azar A
AD  - Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic in Arizona, 
      Phoenix, Arizona, USA.
FAU - Rank, Matthew A
AU  - Rank MA
FAU - Zarka, Matthew A
AU  - Zarka MA
FAU - Chang, Yu-Hui
AU  - Chang YH
FAU - Lal, Devyani
AU  - Lal D
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Am J Rhinol Allergy
JT  - American journal of rhinology & allergy
JID - 101490775
RN  - 37341-29-0 (Immunoglobulin E)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Chronic Disease
MH  - Endoscopy
MH  - Female
MH  - Fungi/*isolation & purification
MH  - Humans
MH  - Immunoglobulin E/*blood
MH  - Male
MH  - Middle Aged
MH  - Paranasal Sinuses/microbiology/*surgery
MH  - Rhinitis/*immunology/microbiology/surgery
MH  - Sex Characteristics
MH  - Sinusitis/*immunology/microbiology/surgery
EDAT- 2017/11/11 06:00
MHDA- 2018/08/09 06:00
CRDT- 2017/11/11 06:00
PHST- 2017/11/11 06:00 [entrez]
PHST- 2017/11/11 06:00 [pubmed]
PHST- 2018/08/09 06:00 [medline]
AID - 10.2500/ajra.2017.31.4471 [doi]
PST - ppublish
SO  - Am J Rhinol Allergy. 2017 Nov 1;31(6):370-375. doi: 10.2500/ajra.2017.31.4471.