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Immunoglobulin disorders in pediatric chronic rhinosinusitis

Callum Lewandrowski1, Brian P Peppers1, Chadi A Makary2

  • 1Division of Adult and Pediatric Allergy and Immunology, Department of Pediatrics.

Current Opinion in Allergy and Clinical Immunology
|December 26, 2025
PubMed

Insights

Children with chronic rhinosinusitis (CRS) have a higher prevalence of primary antibody deficiencies (PAD). Early diagnosis and multidisciplinary care are crucial for managing these conditions.

Area of Science:

  • Pediatric Immunology
  • Otolaryngology

Background:

  • Primary antibody deficiencies (PAD) are associated with increased susceptibility to infections.
  • Chronic rhinosinusitis (CRS) in children can be a presenting sign of underlying immune system disorders.

Purpose of the Study:

  • To review the current understanding of primary antibody deficiencies (PAD) in pediatric patients diagnosed with chronic rhinosinusitis (CRS).
  • To highlight the diagnostic and therapeutic approaches for PAD in children with CRS.

Main Methods:

  • Systematic literature review of studies investigating the link between PAD and CRS in children.
  • Analysis of diagnostic criteria and treatment strategies for various PAD subtypes.

Main Results:

  • The prevalence of PAD is significantly higher in children with CRS compared to the general population.
  • Commonly identified PAD include common variable immunodeficiency (CVID), X-linked agammaglobulinemia (XLA), specific antibody deficiency (SAD), IgG subclass deficiency (IGGSD), selective IgA deficiency (SIGAD), and hyperIgM syndrome.
  • Evidence supporting specific treatment options for PAD in CRS remains limited, emphasizing the need for a multidisciplinary approach.

Conclusions:

  • Children with severe PAD may present with chronic rhinosinusitis, recurrent otitis media, and pneumonia.
  • Otolaryngologists play a key role in the early identification of PAD in pediatric patients with CRS.
  • Optimal management necessitates collaboration between otolaryngology and clinical immunology specialists.
Abstract

Keywords:
antibody deficiencychildrenchronic rhinosinusitisimmunodeficiency disorders

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