Format

Send to

Choose Destination
J Allergy Clin Immunol Pract. 2015 Mar-Apr;3(2):236-42. doi: 10.1016/j.jaip.2014.09.022. Epub 2014 Nov 25.

Clinical characteristics of adults with chronic rhinosinusitis and specific antibody deficiency.

Author information

1
Feinberg School of Medicine, Northwestern University, Chicago, Ill.
2
Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Medicine, College of Medicine, The University of Arizona, Tucson, Ariz.
3
Division of Allergy-Immunology, Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Ill.
4
Division of Allergy-Immunology, Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Ill; Department of Otolaryngology-Head and Neck Surgery, Feinberg School of Medicine, Northwestern University, Chicago, Ill.
5
Department of Otolaryngology-Head and Neck Surgery, Feinberg School of Medicine, Northwestern University, Chicago, Ill.
6
Division of Allergy-Immunology, Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Ill. Electronic address: anjupeters@northwestern.edu.

Abstract

BACKGROUND:

Specific antibody deficiency (SAD) involves a deficient response to a polysaccharide vaccine in the setting of normal immunoglobulin G (IgG) levels and chronic infections. Patients with chronic rhinosinusitis (CRS) are often evaluated for SAD. There are limited data that describe patients with CRS and SAD.

OBJECTIVE:

The objective of this study was to better characterize the role of SAD in CRS.

METHODS:

We reviewed electronic records of adults with CRS who were evaluated for immunodeficiency with quantitative Ig levels and pre- and postantibody titers to a pneumococcal polysaccharide vaccine (PPV).

RESULTS:

Fourteen pneumococcal serotypes were determined in 239 subjects from 2002 to 2009. Of these subjects, 64 had adequate protective titers of 1.3 μg/mL or higher in 7 or more serotypes of the 14 serotypes checked; 56 (23%) had less than 7 protective titers post-PPV and were diagnosed with SAD; and 119 had an adequate response to the vaccine with 7 or more serotypes being higher than 1.3 μg/mL (>50% response) and were characterized as "responders." Subjects with SAD received more antibiotic courses relative to responders in the 2 years after immunization (3.19 ± 2.64 vs 2.19 ± 2.24, P < .05). Of 56 subjects with SAD, 10 (17.9%) received Ig replacement therapy. Subjects who received Ig had fewer numbers of protective pneumococcal titers post-PPV and had more pneumonia (40.0%) versus subjects with SAD who did not receive Ig (10.9%).

CONCLUSIONS:

Of the 239 patients with CRS with normal IgG levels evaluated for immunodeficiency, 56 (23.4%) had SAD. A majority of patients with SAD may not need Ig replacement; however, a subset of patients with SAD benefit from Ig replacement.

KEYWORDS:

Chronic rhinosinusitis; Immunoglobulin replacement therapy; Pneumococcal antibody concentration; Primary immunodeficiency; Specific antibody deficiency

PMID:
25609325
PMCID:
PMC4391952
DOI:
10.1016/j.jaip.2014.09.022
[Indexed for MEDLINE]
Free PMC Article

Supplemental Content

Full text links

Icon for Elsevier Science Icon for PubMed Central
Loading ...
Support Center