Several studies have shown a high prevalence of immunoglobulin deficiencies in patients with chronic rhinosinusitis (CRS).
This systematic review and meta-analysis included all case series published after 1990 describing patients with CRS, which was defined as symptomatic rhinosinusitis for more than 12 weeks and documented immunoglobulin deficiencies (including deficiencies of IgG with subclasses, IgA, and IgM; specific antibody deficiencies; and potential common variable immunodeficiency).
Left-sided maxillary sinusitis (absence of the air transparency of left maxillar sinus). Image source: Wikipedia, public domain.
The results showed:
- prevalence of respiratory allergies in patients with recurrent CRS (31% to 72%)
- prevalence of pooled IgG, IgA, and IgM deficiencies in 13% of patients with recurrent CRS and 23% of patients with difficult-to-treat CRS
- prevalence of IgG subclass deficiency (5% to 50%) and specific antibody deficiency (8% to 34%) in patients with CRS
Immunoglobulin deficiency is a frequent condition in patients with CRS. An even higher prevalence of atopy was observed in patients with recurrent CRS.
Therefore immunoglobulin titers and accurate allergy diagnostic workups are strongly recommended in these patients to provide specific treatments for symptom alleviation.
Immunoglobulin deficiency in patients with chronic rhinosinusitis: Systematic review of the literature and meta-analysis. Schwitzguébel AJ et al. J Allergy Clin Immunol. 2015 Aug 29.