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Immunoglobulin deficiencies higher in patients with recurring chronic rhinosinusitis

Patients with recurrent chronic rhinosinusitis demonstrated a significantly high prevalence of immunoglobulin deficiencies, according to results of a systematic review.

“By demonstrating a greater than 10-fold higher prevalence of immunoglobulin deficiencies in patients with recurrent [chronic rhinosinusitis (CRS)], especially those with difficult-to-treat CRS, the results of the present study are of relevance for both patients with CRS and the field of immune deficiency in total,” Adrien J.-P. Schwitzguébel, MD, division of immunology and allergy at University Hospitals and Medical Faculty in Switzerland, and colleagues wrote. “Apart from treating the symptoms of CRS in a timely manner, it is important to evaluate patients with CRS for early diagnosis of [common variable immunodeficiency (CVID)].”

Schwitzguébel and colleagues conducted both a meta-analysis and a systematic review to estimate the prevalence of immunoglobulin deficiency in patients with CRS.

The analysis included 13 studies of 1,418 adults published in English after 1990. The researchers gathered the data from the Cochrane Library, Medline, Embase and Ovid databases.

Thirteen percent of patients with recurrent CRS and 23% of patients with difficult-to-treat CRS demonstrated a prevalence of pooled immunoglobulin G (IgG), IgA and IgM deficiencies. Patients with recurrent CRS (31%-72%) had an increased prevalence of respiratory allergies.

It is vastly important to identify immunoglobulin deficiencies in patients with CRS, according to Schwitzguébel and colleagues.

“Early CVID diagnosis improves outcomes by allowing for more specific treatment approaches, including aggressive antibiotic therapy and IgG replacement, and by identifying and avoiding associated complications,” the researchers wrote. “Moreover, unnecessary and ineffective surgical procedures can be avoided because patients with difficult-to-treat CRS have an average of three sinus surgeries before being assessed for humoral immune deficiency.”

Disclosure: Schwitzguébel reports no relevant financial disclosures. Please see the full study for a list of all other researchers’ relevant financial disclosures.