The impact of primary immunodeficiency on the severity of chronic rhinosinusitis

• Published in: American journal of otolaryngology 2025-01, Vol.46 (1), p.104541, Article 104541
• Main Authors: Tie, Kevin, Aboueisha, Mohamed A., Wang, Madelyn, Caradonna, David S., Brook, Christopher D.
• Format: Article
• Language: English
• Subjects: Acute rhinosinusitis; Chronic rhinosinusitis; Functional endoscopic sinus surgery; IgA deficiency; IgG deficiency; Primary immunodeficiency
• ISSN: 0196-0709; 1532-818X; 1532-818X
• DOI: 10.1016/j.amjoto.2024.104541

Primary immunodeficiency has been associated with chronic rhinosinusitis (CRS). However, limited evidence exists on how primary immunodeficiencies affect the severity of CRS. To assess how primary IgA and/or IgG immunodeficiency affects the severity of CRS. Adult patients at the Beth Israel Deaconess Medical Center in Boston with IgA and/or IgG deficiency (group A) or normal IgA and IgG (group B) were queried between January 1, 2016 and December 31, 2022. Other immunodeficiencies were excluded. The groups were analyzed for prevalence of CRS based on ICD-10 codes. The groups were matched based on demographics and comorbidities. Patients with CRS were analyzed for ≥3 acute rhinosinusitis (ARS) episodes, mean lifetime ARS episodes, and mean ARS episodes per year (all with or without antibiotic treatment). Additional analyses included need for functional endoscopic sinus surgery (FESS) and mean lifetime FESS procedures based on CPT codes. A logistic regression analysis was then performed over the same parameters. A total of 346 patients had IgA and/or IgG deficiency (group A), and 11,438 patients had normal IgA and IgG (group B). CRS prevalence was higher in group A than group B (12 % vs. 5 %; p