xRead - Nasal Obstruction (September 2024) Full Articles

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440

International consensus statement on rhinosinusitis

(Continues)

Of 8 CRS pts on IVIG treatment, all but 1 had improvement in symptoms.

IgG3 subclass deficiency is the most common IgG subclass deficiency. The majority of patients treated with Ig

responded by reduction in frequency of infections and requirement of antibiotics.

Revision ESS rate for patients with immunodeficiency were 14%. CRSsNP

subtypes with immunodeficiency merit further investigation to optimize outcomes.

In the sample patients, IVIG was not sufficient to prevent chronic sinus inflammation.

In patients with hypogammaglobulinemia, the main infections were RS and pneumonia,

and airway manifestations prevailed. Most patients received prophylactic antibiotic therapy.

CRS patients on immunotherapy exhibit histopathology and disease severity more similar to CRSsNP with trends toward increased neutrophilia and reduced fibrosis.

In the appropriate clinical context, discontinuing or changing a patient’s

immunosuppressive regimen may be a valid treatment option in patients with CRS.

Study Year LOE Study Design Study Groups Clinical Endpoint Conclusions MRI.

Rose 1282 2006 4 Case-control study CVID (n = 13) Selective IgA deficiency (n = 10) Control (n = 14) Blood and nasal lavage after IVIG tested for -IgG, IgA, IgM -ECP, IL-8, TNF- α . Subset (n = 22) on IVIG

treatment, resolution of symptoms.

Upper and lower respiratory tract infections.

Proportions and absolute numbers of specific CD-type T cells.

Endoscopic sinus surgery (ESS) outcome, revision rate.

Clinical and laboratory characteristics.

Lund–Mackay score (LMS), and sinonasal outcome test 22 scores.

Histopathology variables,

CRS patients undergoing ESS with a single surgeon. 5% (n = 21) with immunodeficiency.

Lucuab-Fegurgur 1285 2019 4 Case series 62 patients with selective IgM deficiency, varying clinical manifestations Pimenta 930 2019 4 Cross-sectional 8 patients with

Khokar 947 2019 4 Case series 78 adult patients with IgG subclass deficiency

hypogammaglobulinemia (age 16-65)

36 CRSwNP, and 56 CRSsNP

Papagiannopoulos 1290 2018 4 Retrospective review 15 CRS patients on immunotherapy,

Miglani 1292 2018 4 Retrospective review Retrospective review of 424 adult

TABLE IX-44 (Continued)