Correlation of Nasal Smear Eosinophils, Serum IgE Levels, and Absolute Eosinophil Counts with Clinical Severity in Allergic Rhinitis: A Tertiary Care Study

Abstract

Allergic rhinitis (AR) is a widespread chronic inflammatory disorder of the upper airway that has a steady increase in global prevalence. The markers such as nasal smear eosinophils (NSE), serum immunoglobulin E (IgE), and absolute eosinophil count (AEC) are associated with allergic conditions but their specific applicability in determining the severity of AR symptoms remains inadequately described.

Objective:

To investigate the association between NSE, serum IgE, and AEC with nasal symptom severity in allergic rhinitis patients, evaluated by the Total Nasal Symptom Score (TNSS).

Materials and Methods:

This is a prospective observational study conducted at a tertiary healthcare centre from April 2023 to October 2024. Seventy patients were selected with the diagnosis of Allergic rhinitis based on ARIA guidelines. Nasal smears were collected with the help of nasal swabs and stained using May-Grunwald-Giemsa method. Serum IgE levels were measured via ELISA, and AEC was calculated by manual differential white blood cell counts. TNSS was used to evaluate the severity of clinical symptoms. Data analysis involved descriptive statistics, Pearson’s correlation, and chi-square tests, with statistical significance set at p < 0.05.

Results:

NSE, AEC, and serum IgE levels exhibited a significant positive correlation with TNSS (p < 0.0001). Average NSE percentages were found to be 9.62% in patients with mild symptoms, 18.32% in moderate, and 30.60% in severe cases. Both AEC and serum IgE levels increased consistently with increased severity of symptoms. Spearman’s correlation depicted the strongest association between TNSS and serum IgE (r = 1.0), followed by NSE (r = 0.832) and AEC (r = 0.574).

Conclusion:

Serum IgE, NSE, and AEC are effective biomarkers for evaluating symptom severity in patients with allergic rhinitis. Incorporating these parameters into standard clinical assessment protocols could enhance disease tracking and aid in tailoring personalized treatment approaches.