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Immunologic defects in patients with refractory sinusitis.

G G Shapiro1, F S Virant, C T Furukawa

  • 1Department of Pediatrics, University of Washington School of Medicine, Seattle.

Pediatrics
|March 1, 1991
PubMed
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Many patients with chronic sinusitis show immune system deficiencies. These immune issues, alongside allergies, may contribute to persistent sinus infections, impacting treatment strategies for refractory sinusitis.

Area of Science:

  • Immunology
  • Otolaryngology

Background:

  • Chronic sinusitis is a prevalent condition often requiring allergy evaluation.
  • Recurrent otitis media and asthma exacerbations are frequently observed in patients with chronic sinusitis.

Purpose of the Study:

  • To assess immunologic competence in patients with chronic sinusitis.
  • To identify potential immune deficiencies contributing to refractory sinusitis.

Main Methods:

  • Evaluated 61 patients with chronic sinusitis for immune competence.
  • Assessed quantitative serum immunoglobulin levels, IgG subclass levels, and vaccine responses (pneumococcal and Haemophilus influenzae).
  • Included allergy testing (prick and intradermal tests) to identify atopy.

Main Results:

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  • 34 of 61 patients exhibited abnormal immune study results.
  • Common findings included depressed IgG3 levels and poor response to pneumococcal antigen.
  • Allergic components were suggested by elevated IgE levels (5 patients) and positive skin tests (22 patients).
  • 12 patients had significant intradermal test reactivity, indicating potential atopy.

Conclusions:

  • Immunologic incompetence, particularly involving immunoglobulin deficiencies and poor vaccine response, is prevalent in patients with chronic, refractory sinusitis.
  • Both allergic and immunologic factors likely play significant roles in the etiology of chronic sinusitis.
  • Immune studies are valuable in understanding and managing refractory sinusitis cases.