xRead - Olfactory Disorders (September 2023)

20426984, 2022, 4, Downloaded from https://onlinelibrary.wiley.com/doi/10.1002/alr.22929, Wiley Online Library on [04/09/2023]. See the Terms and Conditions (https://onlinelibrary.wiley.com/terms-and-conditions) on Wiley Online Library for rules of use; OA articles are governed by the applicable Creative Commons License

585

PATEL et al.

TABLE IX-24 (Continued) Study

Year LOE Disease

Study design Study groups

Clinical end point Conclusions treatment may be useful for smell

function, although there was no control groupand no time restriction controlling for spontaneous resolution

Selhub

2000 4

VitaminB,

Review

Review articles

Vitamin B and

Cognitive

et al 1515

neurocognitive function

homocysteine relationship with neurocognitive function

dysfunction maybe

related with low vitamin B level and highhomo cysteine concentra tions AN = anorexia nervosa; IDA = iron deficiency anemia; LOE = level of evidence; OE = olfactory epithelium; OF = olfactory function; SS-TDI = Sniffin’ Sticks threshold, discrimination, identification combination; UPSIT R = University of Pennsylvania Smell Identification Test.

The treatment of OD secondary to endocrine, metabolic, autoimmune, and vitamin and mineral deficiency should be based on the treatment of the primary disorder. Investigating the treatment of metabolic and endocrinologic diseases in patients to improve OD Aggregate grade of evidence : C (Level 2: four studies; Level 3: five studies; Level 4: four studies). Benefit : In patients with OD, evaluation for metabolic and endocrinologic diseases may potentially help diag nose the reason for OD. The correction of hypothyroidism, preventing complications with DM, and weight loss after bariatric surgery can lead to improvements in OD asso ciated with these underlying systemic diseases after treat ment. Harm : Known potential side effects and adverse events associated with medical and surgical treatments aimed at correcting these underlying diseases. Cost : Cost of medical or surgical treatments. Benefits-harm assessment : Potential prevention of other systemic complications of hypothyroidism, DM, and obesity. Value judgments : Endocrine and metabolic diseases can cause OD and correcting these can correct OD.

Policy level : Evaluating and treating patients with olfactory disorders and suspected or known DM, hypothy roidism, or obesity is recommended. Intervention : Laboratory tests, including serum thyroid-stimulating hormone, glucose, and hemoglobin A 1c levels should be considered in individuals with OD and suspected hypothyroidism or DM, and referrals to specialists who can treat these underlying disorders should be made. Investigating and treating autoimmune diseases in patients with related OD Aggregate grade of evidence : C (Level 2b: three stud ies; Level 4: four studies). Benefit : In patients with OD, evaluation for autoim mune diseases, especially Sjögren syndrome, SLE, and IgG4-related disease may potentially help with diagnosis and treatment. Harm : Known potential side effects and adverse events associated with medical treatments. Cost : Cost of medical treatments aimed at underlying disorder. Benefits-harm assessment : May prevent other sys temic complications of autoimmune diseases.