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Atopic Features and Inflammatory Markers Across Cassano-Graded Adenoid Hypertrophy

Fatih Kaplan1, Bilge Kurnaz Kaplan2, Abdulgani Gülyüz3

  • 1Department of Pediatric Allergy and Immunology, Malatya Training and Research Hospital, 44000 Malatya, Türkiye.

Children (Basel, Switzerland)
|March 28, 2026
PubMed

Insights

Adenoid hypertrophy (AH) severity in children is linked to eosinophilia, not IgE sensitization. Eosinophil assessment can help evaluate AH severity.

Area of Science:

  • Pediatric Otolaryngology
  • Allergy and Immunology
  • Respiratory Medicine

Background:

  • Conflicting evidence exists regarding the association between adenoid hypertrophy (AH) and atopy.
  • This study investigates whether Cassano-graded AH severity correlates more with inflammatory markers than IgE-mediated sensitization.

Purpose of the Study:

  • To determine the association between adenoid hypertrophy severity and atopic features in children.
  • To differentiate the roles of inflammatory markers versus IgE-mediated sensitization in AH severity.

Main Methods:

  • Retrospective study of 426 children (aged 3-12) diagnosed with AH.
  • Adenoid hypertrophy was graded using the Cassano classification (dichotomized as advanced AH: Stage III-IV).
  • Atopic features assessed included clinical atopy, IgE sensitization, elevated total IgE, and eosinophilia; multivariable logistic regression was used.

Main Results:

  • Advanced AH was independently associated with eosinophilia (aOR 2.07).
  • Clinical atopy was linked to family history, elevated total IgE, and passive smoking.
  • IgE-mediated sensitization was solely associated with family history of atopy.

Conclusions:

  • Adenoid hypertrophy severity in children is associated with eosinophilia, not IgE-mediated sensitization.
  • Eosinophil assessment may improve routine evaluation of AH severity.
Abstract

Keywords:
Cassano classificationadenoid hypertrophyallergic rhinitiseosinophiliapediatricsensitizationtotal IgE

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