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Rhinosinusitis in Adults With Autoimmune Diseases: A Scoping Review
Obadah Tolaymat1, Tyler Wanstreet2, John Dewey2
1West Virginia University School of Medicine, Morgantown, West Virginia, USA.
International Forum of Allergy & Rhinology
|August 3, 2026
Summary
Chronic rhinosinusitis (CRS) is linked to numerous autoimmune diseases, sharing inflammatory pathways. This review highlights associations and suggests targeted screening for better patient outcomes.
Area of Science:
- Immunology
- Rheumatology
- Otolaryngology
Background:
- Chronic rhinosinusitis (CRS) and autoimmune diseases share inflammatory pathways.
- The full scope of associations between autoimmune conditions and CRS is not well-defined.
- Understanding these links is crucial for comprehensive patient care.
Purpose of the Study:
- To map the evidence on relationships between autoimmune diseases and CRS.
- To investigate epidemiologic associations, mechanistic pathways, and clinical outcomes.
- To characterize the breadth of the association between autoimmune disorders and rhinosinusitis.
Main Methods:
- Systematic literature search following PRISMA-ScR guidelines.
- Inclusion of 24 studies examining autoimmune disorders and CRS.
- Data extraction on study design, autoimmune conditions, outcomes, and findings.
Main Results:
- Consistent associations found between CRS and rheumatoid arthritis, Sjögren's syndrome, systemic lupus erythematosus (SLE), and ankylosing spondylitis.
- IgG4-related disease presents a distinct CRS phenotype.
- Mendelian randomization identified causal links between multiple sclerosis, type 1 diabetes, celiac disease, hypothyroidism, and CRS.
- CRS without nasal polyps showed stronger autoimmune links; autoimmune disease worsened quality of life and exacerbations.
Conclusions:
- Shared Th1/Th17 pathways and mucosal immune dysregulation underpin CRS and autoimmune disease links.
- Evidence supports significant associations between multiple autoimmune disorders and rhinosinusitis.
- Future research should prioritize prospective phenotyping, biomarkers, and targeted screening.
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