Nasal polyps are usually found in nonallergic individuals. However, when
nasal polyps and atopy occur together, a special interaction exists. Total and specific
immunoglobulin E (
IgE) are found in significantly greater concentration in
nasal polyp tissue than in serum and tonsil tissue.
Immunoglobulin A (
IgA) is also more concentrated in
nasal polyps than serum. Patients with
nasal polyps and
allergies seem to have a greater recurrence rate after surgical polypectomy. Frequently,
polyp recurrence occurs during specific pollen seasons in sensitive individuals.
Upper respiratory infections are also a precipitating factor for recurrence. Nasal ciliary beat frequency is inhibited in patients with chronic
sinusitis, allergic nasal reactions, and nonspecific nasal
eosinophilia syndromes: nonallergic
rhinitis with eosinophils (NARES) and blood eosinophilic nonallergic
rhinitis (BENARS).
Nasal polyps are frequently associated with these conditions, which may predispose the nasal mucosa to
infections and increased risk for developing
nasal polyps. When
nasal polyps and
allergies occur together, it is important to treat the allergic condition. This takes the form of identifying the
allergens, eliminating them from the environment (if possible) using
antihistamines/
decongestants, and nasal antiinflammatory drugs such as topical
steroids. Hyposensitization may be considered in resistant cases.