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Immune dysfunction in refractory sinusitis in a tertiary care setting.

L Chee1, S M Graham, D G Carothers

  • 1Department of Otolaryngology--Head and Neck Surgery, University of Iowa, Iowa City, USA.

The Laryngoscope
|February 24, 2001
PubMed
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Primary immunodeficiency states are a significant cause of refractory sinusitis. Immunological testing is crucial for diagnosing immune dysfunction in patients with persistent sinusitis.

Area of Science:

  • Immunology
  • Otolaryngology

Background:

  • Refractory sinusitis affects a significant number of patients.
  • Primary immunodeficiency states are rare but can contribute to chronic infections.

Purpose of the Study:

  • To investigate the role of primary immunodeficiency states in patients with refractory sinusitis.
  • To determine the incidence of immune dysfunction in this patient group.

Main Methods:

  • Retrospective chart review of 316 patients with sinusitis referred for immunological evaluation.
  • Inclusion criteria: at least one sinus surgery or recurrent sinusitis (3+ times/year).
  • Exclusion criteria: HIV, allergic fungal sinusitis, cystic fibrosis, primary ciliary dyskinesia.

Main Results:

Related Experiment Videos

  • 50.6% of patients had positive skin tests for aeroallergens.
  • 40% of patients were anergic to delayed hypersensitivity.
  • Significant rates of abnormal T-lymphocyte function and low immunoglobulin levels were observed.
  • Common variable immunodeficiency (CVID) diagnosed in 9.9%, selective IgA deficiency in 6.2%.

    • Conclusions:

    • An unexpectedly high incidence of immune dysfunction was found in patients with refractory sinusitis.
    • Immunological testing should be a routine part of evaluating patients with persistent sinusitis.