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

Area of Science:

• Immunology
• Otolaryngology
• Epidemiology

Background:

• Chronic rhinosinusitis (CRS) encompasses conditions like CRS without nasal polyposis (CRSsNP) and CRS with nasal polyposis (CRSwNP).
• Autoimmune diseases involve the immune system mistakenly attacking the body's own tissues.
• Understanding the interplay between autoimmune conditions and CRS is crucial for patient management.

Purpose of the Study:

• To investigate the association between various autoimmune diseases and the development of CRSsNP and CRSwNP.
• To determine if autoimmune diseases increase the likelihood of requiring endoscopic sinus surgery for CRS.

Main Methods:

• A multicenter retrospective study utilized the TriNetX database, analyzing data from 106 US healthcare organizations.
• Adult patients (over 18) with diagnosed autoimmune diseases were compared to a control group without autoimmune diseases.
• Outcomes assessed included incidence of CRSsNP, CRSwNP, and need for endoscopic sinus surgery.

Main Results:

• Patients with certain autoimmune diseases exhibited higher rates of both CRSsNP and CRSwNP.
• Specific autoimmune diseases like Graves' disease, multiple sclerosis, rheumatoid arthritis, and systemic lupus erythematosus were linked to increased surgery rates in CRSsNP patients.
• Eosinophilic esophagitis, Hashimoto's disease, and ulcerative colitis were associated with higher surgery rates in CRSwNP patients.

Conclusions:

• A significant association exists between a range of autoimmune diseases and the occurrence of CRSsNP and CRSwNP.
• Rheumatoid arthritis and Graves' disease were identified as autoimmune conditions strongly correlated with a higher need for sinus surgery.