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World J Clin Cases. Dec 16, 2014; 2(12): 873-882
Published online Dec 16, 2014. doi: 10.12998/wjcc.v2.i12.873
Eosinophilic chronic rhinosinusitis in East Asians
En-Tong Wang, Yan Zheng, Peng-Fei Liu, Li-Juan Guo
En-Tong Wang, Yan Zheng, Peng-Fei Liu, Li-Juan Guo, Department of Otolaryngology, Head and Neck Surgery, Air Force General Hospital, Beijing 100142, China
Author contributions: Wang ET contributed to the study design and wrote the review; Zheng Y, Liu PF and Guo LJ were involved in the acquisition, analysis and interpretation of data.
Correspondence to: En-Tong Wang, MD, PhD, Department of Otolaryngology, Head and Neck Surgery, Air Force General Hospital, 30 Fucheng Road, Beijing 100142, China. wang_entong@sina.com
Telephone: +86-10-88420757 Fax: +86-10-88420757
Received: June 25, 2014
Revised: August 28, 2014
Accepted: September 16, 2014
Published online: December 16, 2014
Processing time: 175 Days and 19.9 Hours
Abstract

Chronic rhinosinusitis (CRS) is a common disease worldwide, with a prevalence rate of 5%-15% in the general population. CRS is currently classified into two types: CRS with and without nasal polyps. CRS may also be divided into eosinophilic CRS (ECRS) and non-ECRS subtypes based on the presence of tissue eosinophilic infiltration or not. There are significant geographic and ethnic differences in the tissue eosinophilic infiltration, which is predominant in Western white patients and less common in East Asians, despite an increasing tendency for its prevalence in East Asia countries. ECRS differs significantly from non-ECRS in clinical characteristics, treatment outcomes and strategies, and underlying pathogenic mechanisms. ECRS commonly demonstrates more severe symptoms, polyp diseases with a higher incidence of bilateral polyps and sinonasal diseases on computed tomography, and the increase in blood eosinophils. ECRS is considered a special and recalcitrant subtype of CRS, commonly with poor treatment outcomes compared to non-ECRS. The differentiation of specific subtypes and clinical features of CRS will be important for developing novel treatment strategies and improving treatment outcomes for individual phenotypes of CRS. This review discusses clinical features, diagnosis, treatment and prognosis of ECRS in East Asians.

Keywords: Chronic rhinosinusitis; Eosinophilic chronic rhinosinusitis; Eosinophils; Chronic rhinosinusitis with nasal polyps; Nasal polyps

Core tip: Chronic rhinosinusitis (CRS) is a common disease and currently classified into two types based on presence or absence of nasal polyps. CRS may also be subtyped into eosinophilic CRS (ECRS) and non-ECRS according to the presence of predominant tissue eosinophilic infiltration or not. ECRS differs significantly from non-ECRS in clinical characteristics, treatment outcomes and strategies, and underlying pathogenic mechanisms. ECRS is considered a special and recalcitrant subtype of CRS. The identification of ECRS is helpful to develop treatment strategies for this CRS subtype. Herein we review the clinical features, diagnosis, treatment and prognosis of ECRS in East Asians.