Nasal polyps and immunoglobulin E (IgE)

Nasal polyps are usually found in nonallergic individuals. However, when nasal polyps and atopy occur together, a special interaction exists. Total and specific immunoglobulin E (IgE) are found in significantly greater concentration in nasal polyp tissue than in serum and tonsil tissue. Immunoglobulin A (IgA) is also more concentrated in nasal polyps than serum. Patients with nasal polyps and allergies seem to have a greater recurrence rate after surgical polypectomy. Frequently, polyp recurrence occurs during specific pollen seasons in sensitive individuals. Upper respiratory infections are also a precipitating factor for recurrence. Nasal ciliary beat frequency is inhibited in patients with chronic sinusitis, allergic nasal reactions, and nonspecific nasal eosinophilia syndromes: nonallergic rhinitis with eosinophils (NARES) and blood eosinophilic nonallergic rhinitis (BENARS). Nasal polyps are frequently associated with these conditions, which may predispose the nasal mucosa to infections and increased risk for developing nasal polyps. When nasal polyps and allergies occur together, it is important to treat the allergic condition. This takes the form of identifying the allergens, eliminating them from the environment (if possible) using antihistamines/decongestants, and nasal antiinflammatory drugs such as topical steroids. Hyposensitization may be considered in resistant cases.