Association Between Granular Changes on Epipharyngeal Endoscopy and Allergen Sensitization in Chronic Epipharyngitis.

Background

Granular changes observed under band-limited epipharyngeal endoscopy are considered a characteristic finding of chronic epipharyngitis; however, their biological significance remains unclear. This study investigated whether granular changes are associated with allergen sensitization and peripheral allergic biomarkers in patients with chronic epipharyngitis.

Methods

A retrospective analysis was conducted in 59 patients with chronic epipharyngitis. Granular changes were graded endoscopically as 0 (absent), 1 (mild-to-moderate), or 2 (severe). Nasal eosinophil counts, peripheral blood eosinophil counts, total immunoglobulin E (IgE), mite-specific IgE, house dust-specific IgE, and peripheral blood CD4/CD8 ratios were evaluated. Comparisons among groups were performed using the Kruskal-Wallis and Mann-Whitney U tests, and correlations were assessed using Spearman's rank correlation analysis.

Results

Patients with granular changes demonstrated significantly higher mite-specific IgE and house dust-specific IgE levels than those without granular changes. In comparisons between patients without granular changes (grade 0) and those with granular changes (grades 1 and 2), significant differences were observed for mite-specific IgE (p = 0.016) and house dust-specific IgE (p = 0.016). In contrast, nasal eosinophil counts, peripheral blood eosinophil counts, total IgE levels, and CD4/CD8 ratios showed no significant associations with granular changes. Furthermore, Spearman correlation analysis revealed no significant correlations between granular change scores and any evaluated biomarker.

Conclusions

Granular changes on epipharyngeal endoscopy were associated with sensitization to mite and house dust allergens but were not associated with peripheral eosinophil counts, total IgE levels, or CD4/CD8 ratios. These findings suggest that the presence of granular changes may be associated with allergen sensitization; however, no association with increasing granular severity was observed. Further studies incorporating local immune profiling and cytokine analyses are warranted to clarify the biological significance of granular changes.