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<p>Conventional wisdom suggests that larger adenoid size correlates with greater airway obstruction and associated symptoms. Recent studies suggest that local allergic inflammation, particularly eosinophilic infiltration, may contribute to the pathogenesis of adenoid hypertrophy (AH). However, the interplay between adenoid size, histopathological inflammation and systemic immune markers remains unclear. This study investigated the associations between immunological markers [serum IgE, absolute eosinophil count (AEC)], tissue histopathological findings (eosinophil and neutrophil counts) and clinical features (Recurrent Rhinitis, SRBD, OME, and Adenoid Grade) in pediatric patients undergoing adenoidectomy. A prospective observational study was conducted involving children posted for adenoidectomy, who were classified based on ARIA guidelines 2019 into 2 groups- allergic and non-allergic. Preoperative measurements of serum IgE and AEC were obtained and histopathological examination of adenoid tissue was performed postoperatively. Among 60 participants included in our study, 21 were allergic and 39 non-allergic. Although serum IgE levels were elevated in the allergic group, it was not statistically significant (<i>p</i> = 0.08) when compared to the non allergic group. This study revealed weak correlations between adenoid size and clinical parameters. Adenoid grade did not significantly correlate with serum IgE, AEC, or tissue eosinophil counts. Tissue neutrophil counts were higher in the non-allergic group than in the allergic group, although this group difference was not statistically significant. Notably, tissue neutrophil counts were significantly higher in patients with otitis media with effusion (OME) (<i>p</i> = 0.004), indicating a predominance of neutrophilic inflammation in this subgroup. Adenoid-related pathologies are multifactorial, with no single parameter serving as a strong predictor. These findings demonstrate a limited correlation between systemic allergic markers and adenoid tissue eosinophilia.</p>

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Correlation of Immunological, Histopathological and Clinical Parameters in Pediatric Patients with Adenoid Hypertrophy

  • 期刊论文

  • 发表日期：

    2026年7月31日

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  • Sanu P. Moideen,
  • Irine Aleyamma Thomas,
  • Neenu Anna Joseph,
  • K. P. Jabir Bin Umer,
  • Febin James,
  • Nithin Mohan,
  • Angel Cham Philip,
  • Ramiya Ramachandra Kaipuzha,
  • Davis Thomas Pulimoottil

摘要

Conventional wisdom suggests that larger adenoid size correlates with greater airway obstruction and associated symptoms. Recent studies suggest that local allergic inflammation, particularly eosinophilic infiltration, may contribute to the pathogenesis of adenoid hypertrophy (AH). However, the interplay between adenoid size, histopathological inflammation and systemic immune markers remains unclear. This study investigated the associations between immunological markers [serum IgE, absolute eosinophil count (AEC)], tissue histopathological findings (eosinophil and neutrophil counts) and clinical features (Recurrent Rhinitis, SRBD, OME, and Adenoid Grade) in pediatric patients undergoing adenoidectomy. A prospective observational study was conducted involving children posted for adenoidectomy, who were classified based on ARIA guidelines 2019 into 2 groups- allergic and non-allergic. Preoperative measurements of serum IgE and AEC were obtained and histopathological examination of adenoid tissue was performed postoperatively. Among 60 participants included in our study, 21 were allergic and 39 non-allergic. Although serum IgE levels were elevated in the allergic group, it was not statistically significant (p = 0.08) when compared to the non allergic group. This study revealed weak correlations between adenoid size and clinical parameters. Adenoid grade did not significantly correlate with serum IgE, AEC, or tissue eosinophil counts. Tissue neutrophil counts were higher in the non-allergic group than in the allergic group, although this group difference was not statistically significant. Notably, tissue neutrophil counts were significantly higher in patients with otitis media with effusion (OME) (p = 0.004), indicating a predominance of neutrophilic inflammation in this subgroup. Adenoid-related pathologies are multifactorial, with no single parameter serving as a strong predictor. These findings demonstrate a limited correlation between systemic allergic markers and adenoid tissue eosinophilia.