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Blood eosinophil percentage as a triage signal in pediatric allergic Rhinitis: Data-Driven cut-offs from a public cohort

Blood eosinophil percentage as a triage signal in pediatric allergic Rhinitis: Data-Driven cut-offs from a public cohort

Xiaoxiao Huang ¹, Jun Chen ¹, Tong Wu ², Chi Wang ¹, Bo Ning ¹, Lijuan Yang ³

Xiaoxiao Huang ¹, Jun Chen ¹, Tong Wu ²

¹Department of Otolaryngology, Xuzhou Central Hospital, Xuzhou, Jiangsu, China.
²Department of Otorhinolaryngology, Head and Neck Surgery, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China; Department of Otolaryngology, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China.
³Department of Otolaryngology, Xuzhou Central Hospital, Xuzhou, Jiangsu, China; Department of Otolaryngology, Xuzhou Rehabilitation Hospital, Xuzhou, Jiangsu, China.

⁰Department of Otolaryngology, Xuzhou Central Hospital, Xuzhou, Jiangsu, China.

International Journal of Pediatric Otorhinolaryngology +

|

December 19, 2025

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View abstract on PubMed

Summary

This summary is machine-generated.

Peripheral blood eosinophil percentage (Eos %) shows modest ability to triage children with allergic rhinitis (AR). While Eos % can aid in symptom burden assessment, it is insufficient alone for accurate diagnosis.

Area Of Science

Pediatric Allergy and Immunology
Clinical Diagnostics
Biomarker Research

Background

Clinicians require simple tools for triaging pediatric allergic rhinitis (AR) patients based on symptom burden.
Peripheral blood eosinophil percentage (Eos %) was investigated as a potential triage biomarker.

Purpose Of The Study

To evaluate the utility of Eos % thresholds for first-pass triage of children with AR.
To determine if Eos % can effectively differentiate between high and low symptom burden in pediatric AR.

Main Methods

Secondary analysis of a pediatric AR dataset including Eos % and Total Nasal Symptom Score (TNSS).
Receiver Operating Characteristic (ROC) analysis and Area Under the Curve (AUC) calculation.
Decision Curve Analysis (DCA) assessed clinical utility for triage thresholds.

Main Results

Eos % demonstrated modest discrimination for high symptom burden (AUC 0.606).
The optimal Youden cut-off was 6.8% Eos %, yielding suboptimal sensitivity (0.53) and specificity (0.68).
Specific thresholds (∼3.7% for sensitivity, ∼8.5% for specificity) showed limited clinical utility.

Conclusions

Eos % has limited discriminatory ability for AR triage in children.
Eos % alone is inadequate for accurate triage and serves only as a complementary signal.
Prospective validation is crucial due to weak performance and potential for false positives.

Keywords:

Allergic rhinitis Decision curve analysis Eosinophil percentage Pediatrics ROC TNSS Thresholds

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Allergic Reactions

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Overview

We speak of an allergy when the immune system triggers a response against a benign foreign structure, like food, pollen or pet dander. These elicitors are called allergens. If the immune system of a hypersensitive individual was primed against a specific allergen, it will trigger allergic symptoms during every subsequent encounter of the allergen. Symptoms can be mild, such as hay fever, to severe, such as potentially fatal anaphylactic shock.

Sensitization Is the First Step of an...

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