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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
Summary
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.
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