Distinct peripheral coagulation-fibrinolysis profiles in eosinophilic and non-eosinophilic chronic rhinosinusitis

Eosinophilic chronic rhinosinusitis (ECRS) is characterized by nasal polyps, type 2 inflammation, and excessive fibrin deposition. Although local dysregulation of coagulation and fibrinolysis is implicated in ECRS pathogenesis, it remains unclear whether these abnormalities involve systemic hemostatic changes.

We enrolled 20 patients with ECRS, 20 with non-ECRS, and 20 controls (patients undergoing septoplasty without CRS). Peripheral blood was collected 1 month preoperatively to measure coagulation and fibrinolysis markers-including fibrin degradation products (FDP), D-dimer, and factor XIII activity-via standard clinical assays. Group differences were assessed using nonparametric tests, and categorical variables were compared using the χ² or Fisher's exact tests.

FDP levels were significantly higher in both the ECRS and non-ECRS groups than in the controls (control vs. non-ECRS, P = 0.011; control vs. ECRS, P = 0.045). D-dimer levels were significantly higher in the non-ECRS group than in the controls (P = 0.002). Factor XIII activity was significantly higher in the ECRS group than in the controls (P = 0.041).

Chronic rhinosinusitis (CRS) may be associated with mild alterations in coagulation and fibrinolysis. In the original cohort, non-ECRS showed a pattern compatible with enhanced coagulation-fibrinolysis turnover, whereas ECRS showed elevated factor XIII activity with possible alterations in fibrin stabilization. Sensitivity analyses suggested that the factor XIII signal in ECRS was relatively robust, whereas the findings for FDP and D-dimer were more sensitive to control group composition. These findings support that CRS, particularly ECRS, is accompanied by subtle systemic hemostatic changes, although further validation required.