Chronic Rhinosinusitis and Autoimmune Diseases: A Comprehensive Large Population-Based Analysis

To evaluate associations between a wide variety of autoimmune diseases and chronic rhinosinusitis without nasal polyposis (CRSsNP), CRS with nasal polyposis (CRSwNP), and the need for endoscopic sinus surgery.

This is a multicenter retrospective study from January 1, 2010 to July 31, 2025 utilizing data from 106 healthcare organizations in the United States. The TriNetX database was used to identify adult patients over 18 years with a specified autoimmune disease from a comprehensive list that were included in the study. These groups were compared to patients without autoimmune diseases. The evaluated outcomes included the rate of developing CRSsNP, CRSwNP, and the need for endoscopic sinus surgery.

Higher rates of CRSsNP and CRSwNP were noted in patients with certain autoimmune diseases. In patients with CRSsNP, a higher likelihood of undergoing sinus surgery was identified for Graves' disease, multiple sclerosis, rheumatoid arthritis, and systemic lupus erythematosus (RR: 1.84 [1.60-2.13]; 1.20 [1.02-1.43]; 1.19 [1.09-1.29]; 1.30 [1.05-1.61]). Among patients with CRSwNP, a higher rate of surgery was associated with eosinophilic esophagitis, Hashimoto's disease, and ulcerative colitis (RR: 1.08 [1.02-1.14]; 1.06 [1.02-1.11]; 1.15 [1.04-1.32]).

A wide variety of autoimmune diseases are associated with CRSsNP and CRSwNP. The autoimmune diseases that were associated with a higher rate of surgery were rheumatoid arthritis and Graves' disease.

3.