CLINICAL ANALYSIS OF ROLE OF BLOOD EOSINOPHIL AND BASOPHIL LEVELS AS PROGNOSTIC MARKER IN ALLERGIC FUNGAL RHINOSINUSITIS (AFRS)

Background: Allergic Fungal Rhinosinusitis (AFRS) is a common disease and denoted as Chronic Rhinosinusitis with polyps (CRSwNP). Presents as Eosinophilic nasal polyps, and allergic mucin in the nose and sinuses demonstrable with Functional Endoscopic sinus surgery (FESS) surgery. The biological markers predicting this disease entity are uncertain. Physicians experience difficult to predict the outcomes of various methods of treatment adopted to treat AFRS. Sometimes involvements of blood inflammatory cells were used to predict the recovery of the disease and its prognosis. Aim of the Study: To study the levels of pre-operative blood Eosinophils and Basophils in patients with AFRS and compare them postoperatively in terms of recurrence of polypi and allergic symptoms. Materials and Methods: 69 adult patients diagnosed with AFRS at the tertiary teaching Hospital in Andhra Pradesh were included. Patients were treated with FESS for AFRS. The final outcomes were assessed on the basis of blood Eosinophils and Basophils and correlating with the recurrence of symptoms and polypi. Results: Recurrence of polypi in 14 of 69 patients with overall review during study period showed that there was a statistically significant positive correlation between recurrences and blood Eosinophils and Basophils counts. But there was no correlation between the blood and tissue Mast cells.  Conclusions: The study pointed to the patients at higher risk of AFRS recurrence with high counts of blood Eosinophils, Basophils. Further investigations are needed to study the role of higher levels of Blood Eosinophils, Basophils and Tissue Mast cells in AFRS patients during their follow up period of medical or surgical protocols of treatment.