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El riesgo de trastornos reumáticos en pacientes con rinosinusitis: una revisión sistemática y un metanálisis
Arshbir Aulakh1, Pradumn Choudhary1, Gurwinder Sidhu1
1Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.
International forum of allergy & rhinology
|September 5, 2025
Resumen
La rinosinusitis, especialmente la rinosinusitis crónica, está relacionada con un mayor riesgo de desarrollar enfermedades reumáticas como la artritis reumatoide. La detección temprana de los síntomas autoinmunes en pacientes con rinosinusitis es crucial para el diagnóstico y tratamiento oportunos.
Área de la Ciencia:
- Inmunología y Reumatología
- Otorrinolaringología
- Enfermedades autoinmunes sistémicas
Sus antecedentes:
- La evidencia creciente sugiere una conexión entre la rinosinusitis y las enfermedades reumáticas sistémicas.
- Ha faltado un metanálisis exhaustivo que examine esta asociación.
- Es esencial investigar la predisposición de los pacientes con rinosinusitis a las enfermedades reumáticas.
Objetivo del estudio:
- Determinar si los pacientes con rinosinusitis tienen un mayor riesgo de desarrollar enfermedades reumáticas.
- Cuantificar la asociación entre la rinosinusitis y las afecciones reumáticas específicas.
- Explorar el papel potencial de la desregulación inmune de la mucosa en la patogénesis.
Principales métodos:
- Se realizó una búsqueda sistemática de la literatura en las principales bases de datos (MEDLINE, Embase, Cochrane Library, Web of Science) hasta febrero de 2025.
- Se incluyeron estudios centrados en la incidencia, prevalencia y riesgo de enfermedades reumáticas en cohortes de rinosinusitis.
- Los datos relativos de riesgo y prevalencia se agruparon utilizando modelos de efectos aleatorios para nueve estudios incluidos (86.081 pacientes).
Principales resultados:
- La rinosinusitis crónica (CRS) mostró asociaciones significativas con un mayor riesgo de artritis reumatoide (OR: 1.70), lupus eritematoso sistémico (OR: 1.61) y espondilitis anquilosante (OR: 1.48).
- La rinosinusitis aguda (ARS) demostró asociaciones más débiles, en particular con la artritis reumatoide seronegativa.
- La artritis reumatoide tuvo la mayor prevalencia (10%) entre las enfermedades reumáticas en pacientes con rinosinusitis.
Conclusiones:
- La rinosinusitis, en particular la CRS, está significativamente asociada con un riesgo elevado de desarrollar varias enfermedades reumáticas sistémicas.
- La desregulación inmune mucosa en la rinosinusitis puede desempeñar un papel en el desarrollo de la autoinmunidad sistémica.
- Los médicos deben mantener un alto índice de sospecha de síntomas autoinmunes tempranos en pacientes con rinosinusitis.
Palabras clave:
Sinusitis aguda de los dientesLa autoinmunidadInsuficiencia renal crónicaEnfermedades reumáticasMás Videos Relacionados
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