xRead - Nasal Obstruction (September 2024) Full Articles

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International consensus statement on rhinosinusitis

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TABLE X-15 Evidence for immunodeficiency as a contributing factor for CRSwNP Study Year LOE Study Design Study Groups Clinical Endpoint Conclusions Mazza 1284 2016 3 Systematic review 39 studies, predominantly level 4 evidence, of patients with PID and CRS Data was collected pertaining to immune dysfunction in patients with CRS, the clinical workup for these patients, and the effectiveness of medical and surgical treatments. No association between the presence of polyps and immunodeficiencies was appreciated; however, some authors concluded that the presence of polyps predicted recalcitrant disease. Schwitzguebel 1513 2015 3 Systematic review and meta-analysis All case series published after 1990 describing patients with CRS, and documented Ig deficiencies (N = 1418) Estimate the prevalence of Ig deficiency in CRS patients Ig deficiency is a frequent condition in patients with CRS. The prevalence of nasal polyposis in these patients varied from 13% to 60%. Keswani 952 2017 4 Case-control 595 patients with CRS who were evaluated for humoral immunodeficiency with quantitative immunoglobulins and Streptococcus pneumoniae antibody titers Humoral status (Ig levels, antibody titers) Clinical characteristics (Lund-Mackay, endoscopy/CT scores, asthma severity) Stratification of SAD by severity demonstrates a significant increase in the comorbid severity of asthma and infections in CRS patients. No difference in nasal polyposis when stratifying by SAD severity. Kashani 946 2015 4 Case series 239 adults with CRS who were evaluated for SAD. Patients were sub-classified as CRSsNP or CRSwNP (n = 50, 27%) Quantitative Ig levels Pre- and post-antibody titers to PPV Within the CRSwNP group, there was no significant difference in the number of protective post-immunization titers based on the presence of asthma.