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

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