Abstract
Objective: 1) Determine the prevalence of immunoglobulin abnormalities in patients with chronic rhinosinusitis. 2) Compare our results with similar studies for validity. 3) Draw conclusions on when to order these specific tests. 4) Alert providers on the prevalence and workup of immune deficiencies.
Method: Retrospective study of all patients with CRS of a single provider, from 2008 to 2010, with attention given to those with refractory CRS on whom immunoglobulin laboratories were ordered. Measured variables were total patients, number of immune laboratories ordered, and results of those tests.
Results: At our institution, 334 patients were seen by a single provider with the diagnosis of CRS. Of these patients, immunoglobulin levels (IgG, IgG subclasses, IgM, IgA, and/or IgE) were ordered on 37 patients. Deficiencies of at least one immunoglobulin class were found on 20 patients (54 percent of patients tested). This demonstrates a 5.9% prevalence of immunoglobulin deficiency in our chronic sinusitis patient population. The most common deficiency noted on this study was an IgG subclass deficiency. Two patients demonstrated common variable immunoglobulinemia.
Conclusion: Despite aggressive medical and surgical therapy, CRS can be a persistent disease. Immunoglobulin deficiency is common in this subset of refractory patients. The clinician should be aware of this likelihood and order appropriate studies. Proper recognition can allow the clinician to tailor their management of these patients.
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