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Published on: March 10, 2016
Nasal Cytology as a Marker of Atopy in Children
Anna Mierzejewska1, Anna Jung1, Bolesław Kalicki1
1Department of Pediatrics, Pediatric Nephrology and Allergology, Central Clinical Hospital of the Ministry of Defence, Military Institute of Medicine, Warsaw, Poland.
Insights
Nasal cytology can help diagnose atopic diseases in children. Increased eosinophils in nasal scrapings indicate atopy, with high specificity for allergic conditions.
Area of Science:
- Pediatric Allergy and Immunology
- Cytopathology
- Diagnostic Medicine
Background:
- Atopic diseases, including atopic dermatitis, asthma, and allergic rhinitis, are common in children.
- Accurate and early diagnosis is crucial for effective management and improved patient outcomes.
- Current diagnostic methods may have limitations in early detection.
Purpose of the Study:
- To assess the cytological features of nasal mucosa in children with atopic diseases.
- To determine the diagnostic utility of nasal cytology for identifying atopy in pediatric populations.
- To evaluate the role of eosinophil counts in nasal smears for diagnosing atopic conditions.
Main Methods:
- A cohort of 140 children (4 months to 17 years) with and without a history of atopy was studied.
- Nasal scrapings were collected using a standardized technique.
- Cytological analysis under light microscopy focused on epithelial and infiltrating cells, particularly eosinophils.
Main Results:
- Eosinophils were significantly more prevalent in children with atopic diseases compared to healthy controls.
- Nasal cytology demonstrated high specificity (94.1%) for detecting atopic diseases.
- Sensitivity varied by condition: allergic rhinitis (52.2%), asthma (33.3%), and atopic dermatitis (13.3%) at a 5% eosinophilia threshold.
Conclusions:
- Nasal cytology, specifically assessing eosinophilia, is a valuable tool for the early diagnosis of atopic diseases in children.
- The test shows high specificity, suggesting its utility in confirming atopy.
- Further refinement may improve sensitivity for specific atopic conditions in pediatric patients.
Abstract:
The aim of this study was to evaluate the cytological picture of nasal mucosa in children with atopic diseases and to determine the diagnostic value of the test for the diagnosis of atopic diseases. The study included 140 children from 4 months to 17 years old. Among children with a history of atopy, there were 30 children with atopic dermatitis, 30 children with asthma, and 46 children with allergic rhinitis. The control group consisted of 34 healthy children. The nasal scraping technique has been used to collect samples from the nasal cavity. The samples were evaluated under light microscope. Epithelial cells as well as infiltrating cells were assessed. The only statistically significant group of cells differentiating children with atopic disease and without atopy were eosinophils, which in children with atopy were significantly more common. Assuming a significant eosinophilia value of at least 5% of all cells in cytogram, the sensitivity of nasal cytology in allergic rhinitis was 52.2%, in asthma 33.3%, and in atopic dermatitis 13.3%. The specificity of the test in atopic diseases was 94.1%. It can be concluded that nasal cytology with eosinophilia assessment can be a useful tool for an early diagnosis of atopic disease in children.
