Correlation Between Serum Immunoglobulin E and Grade III Adenotonsillar Hypertrophy in Children: A Study from the Adjara Region of Georgia

Authors

DOI:

https://doi.org/10.66636/gmj.v1.i2.a82

Keywords:

adenoid hypertrophy, adenotonsillar hypertrophy, allergic rhinitis, mmunoglobulin E, atopy, pediatric otorhinolaryngology, subclinical sensitization, Georgia, Adjara

Abstract

Background  Adenoid and adenotonsillar hypertrophy (AH/ATH) are leading causes of chronic upper airway obstruction in childhood and a frequent indication for pediatric otorhinolaryngologic surgery. The contribution of IgE-mediated atopic sensitization to the pathogenesis of AH/ATH remains incompletely characterised, and regional data from the South Caucasus are scarce. This study examined the relationship between clinical allergic manifestations and total serum immunoglobulin E (IgE) levels in Georgian children undergoing adenotonsillectomy.

Methods  We conducted a single-centre, retrospective, observational, cross-sectional study of 17 consecutive children aged 3–12 years with clinically and endoscopically confirmed Grade III adenoid or adenotonsillar hypertrophy scheduled for elective surgery at a tertiary otorhinolaryngology centre in the Adjara region of Georgia during 2024–2025. Standardised history-taking documented allergic manifestations; preoperative total serum IgE was measured by routine immunoassay and interpreted against age-adjusted reference ranges. Descriptive statistics were used; given the small sample, no inferential testing was performed and results are presented as hypothesis-generating.

Results  Among 17 children (11 boys, 64.7%; mean age 6.2 years), clinical allergic manifestations were documented in 8 (47.1%), predominantly respiratory (6/8; 75.0%). Total serum IgE was elevated in 11 of 17 children (64.7%), with a mean elevated value of 278.16 IU/mL. Elevated IgE was observed at a comparable frequency in children with (5/8; 62.5%) and without (6/9; 66.7%) clinically apparent allergy.

Conclusions  In this pediatric surgical cohort, elevated total serum IgE was frequent in children with Grade III AH/ATH and was not restricted to those with overt clinical allergy, suggesting that subclinical IgE-mediated sensitization may contribute to the pathophysiology of adenotonsillar hypertrophy. Larger studies incorporating allergen-specific IgE testing and non-hypertrophy controls are needed to confirm this signal and to inform pre-operative allergy evaluation pathways.

Keywords  adenoid hypertrophy; adenotonsillar hypertrophy; allergic rhinitis; immunoglobulin E; atopy; pediatric otorhinolaryngology; subclinical sensitization; Georgia; Adjara

References

1. Niedzielski A, Chmielik LP, Mielnik-Niedzielska G, Kasprzyk A, Bogusławska J. Adenoid hypertrophy in children: a narrative review of pathogenesis and clinical relevance. BMJ Paediatr Open. 2023;7(1):e001710. https://doi.org/10.1136/bmjpo-2022-001710

2. Pereira L, Monyror J, Almeida FT, Almeida FR, Guerra E, Flores-Mir C, et al. Prevalence of adenoid hypertrophy: a systematic review and meta-analysis. Sleep Med Rev. 2018;38:101–12. https://doi.org/10.1016/j.smrv.2017.06.001

3. Bernstein JA, Bernstein JS, Makol R, Ward S. Allergic rhinitis: a review. JAMA. 2024;331(10):866–77. https://doi.org/10.1001/jama.2024.0530

4. Bousquet J, Anto JM, Bachert C, Baiardini I, Bosnic-Anticevich S, Walter Canonica G, et al. Allergic rhinitis. Nat Rev Dis Primers. 2020;6(1):95. https://doi.org/10.1038/s41572-020-00227-0

5. Hu Y, Wu W, Liu J, Yang Y, Mao J, Yang X, et al. The role of adenoid immune phenotype in polysensitized children with allergic rhinitis and adenoid hypertrophy. Pediatr Allergy Immunol. 2024;35(6):e14166. https://doi.org/10.1111/pai.14166

6. Quaranta N, Milella C, Iannuzzi L, Gelardi M. A study of the role of different forms of chronic rhinitis in the development of otitis media with effusion in children affected by adenoid hypertrophy. Int J Pediatr Otorhinolaryngol. 2013;77(12):1980–3. https://doi.org/10.1016/j.ijporl.2013.09.018

7. Ahmad Z, Krüger K, Lautermann J, Lippert B, Tenenbaum T, Tigges M, et al. Adenoide Vegetationen — Diagnostik und Therapie: die neue S2k-Leitlinie. HNO. 2023;71:67–72. https://doi.org/10.1007/s00106-023-01299-6

8. Lin Y, Rui X, Li J, Chen J, Li Y. Aeroallergen IgE profile, adenoid hypertrophy, and childhood allergic rhinitis in urban China. Allergy Asthma Proc. 2020;41(6):e63–70. https://doi.org/10.2500/aap.2020.41.200063

9. Wang J, Han D, Zhang L, Tan G, Wang J. Evaluation of the local and systemic pattern of sensitization to allergens in patients with adenotonsillar hypertrophy. Eur Arch Otorhinolaryngol. 2025;282(1):457–66. https://doi.org/10.1007/s00405-024-08941-1

10. National Center for Disease Control and Public Health of Georgia. Statistical Yearbook: Morbidity of Children Aged 0–15 Years, 2018. Tbilisi: NCDC; 2019. Available from: https://www.ncdc.ge/

11. Modrzyński M, Zawisza E. An analysis of the incidence of adenoid hypertrophy in allergic children. Int J Pediatr Otorhinolaryngol. 2007;71(5):713–9. https://doi.org/10.1016/j.ijporl.2006.12.018

12. Koohpayeh Zadeh J, Ghalebaghi B, Dehghani Firouzabadi F, Dehghani Firouzabadi M, Mohseni F, Biglari Abhari M, et al. Allergy status in children with adenoid hypertrophy with and without serous otitis media. Immunopathol Persa. 2022;8(2):e12189. https://doi.org/10.34172/ipp.2022.12189

13. Chiu CY, Chen YL, Tsai MH, Liao SL, Su KW, Yao TC, et al. Longitudinal analysis of total serum IgE levels with allergen sensitization and atopic diseases in early childhood. Sci Rep. 2020;10(1):21278. https://doi.org/10.1038/s41598-020-78272-8

14. Zou J, Yang Y, Fu Q, Liu H, Zhang C, Liu L, et al. Eosinophils are more strongly relevant to allergic sensitization than basophils in pediatric adenotonsillar hypertrophy. Front Pediatr. 2021;9:598063. https://doi.org/10.3389/fped.2021.598063

15. Zhu F, Sun K, Yu L, Sun S, Wan Y, Shi L. Tissue cytokine expression in hypertrophic adenoid gland in children with allergic rhinitis. J Coll Physicians Surg Pak. 2021;31(8):903–9. https://doi.org/10.29271/jcpsp.2021.08.903

16. Chen S, Liu X, Wang Y, Li R, Zhang Q, Sun J. Combination therapy with mometasone furoate and montelukast for adenoid hypertrophy in children: a systematic review and meta-analysis. Int J Pediatr Otorhinolaryngol. 2024;176:111873. https://doi.org/10.1016/j.ijporl.2024.111873

17. Goldbart AD, Goldman JL, Veling MC, Heatley DG, Cohen SP, Carr MM. Montelukast for children with obstructive sleep apnea and adenoid hypertrophy: a systematic review and meta-analysis. Clin Otolaryngol. 2024;49(2):185–93. https://doi.org/10.1111/coa.14015

18. Liu A, Zhang Y, Lin Y, Li X, Wang S, Pu W, et al. A rat model of adenoid hypertrophy constructed using ovalbumin and lipopolysaccharide to induce allergy, chronic inflammation, and chronic intermittent hypoxia. Anim Models Exp Med. 2025;8(2):315–26. https://doi.org/10.1002/ame2.12463

19. World Medical Association. World Medical Association Declaration of Helsinki: ethical principles for medical research involving human subjects. JAMA. 2013;310(20):2191–4. https://doi.org/10.1001/jama.2013.281053

20. von Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vandenbroucke JP; STROBE Initiative. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. Lancet. 2007;370(9596):1453–7. https://doi.org/10.1016/S0140-6736(07)61602-X

Cover of the Georgian Medical Journal (GMJ), Volume 1, Issue 2 (2026), titled “Health Systems Performance and Quality of Care: Measurement, Improvement, and Outcomes,” with a blue world map background representing global health connectivity. Includes the themes “Quality, Safety, Results” and the publisher Public Health Institute of Georgia.

Downloads

Published

05/11/2026

How to Cite

Gogadze, G., & Kokoladze, I. (2026). Correlation Between Serum Immunoglobulin E and Grade III Adenotonsillar Hypertrophy in Children: A Study from the Adjara Region of Georgia. Georgian Medical Journal, 1(2), 1–10. https://doi.org/10.66636/gmj.v1.i2.a82

Issue

Vol. 1 No. 2 (2026): Health Systems Performance and Quality of Care

Section

Original Research

License

Copyright (c) 2026 Gela Gogadze, Irina Kokoladze

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

Open Access · CC BY 4.0

This article is published open access under the Creative Commons Attribution 4.0 International (CC BY 4.0) licence.

You are free to: share and adapt the work for any purpose, even commercially.
Conditions: provide appropriate credit to the authors and the Georgian Medical Journal (GMJ), link to the licence, and indicate if changes were made. Do not apply legal terms or technological measures that legally restrict others from doing anything the licence permits.
Licence: creativecommons.org/licenses/by/4.0  ·  Legal code: creativecommons.org/licenses/by/4.0/legalcode

Third-party material. Images or other content credited to a third party are not covered by CC BY 4.0; permission must be obtained from the rights holder for reuse beyond statutory exceptions.

Authors' rights. Authors retain copyright. First publication rights are granted to GMJ.

Data and code. Where provided, datasets or code may carry their own licences; please follow the licence stated in the article or repository record.

Recommended citation
Author(s). Title. Georgian Medical Journal (GMJ) Year;Volume(Issue):Pages. CC BY 4.0. DOI: 10.66636/xxxxx

Similar Articles

1 2 3 4 5 6 7 8 9 10 11 > >> 

You may also start an advanced similarity search for this article.