(252) Impact of Selective Immunoglobulin Deficiency On Chronic Rhinosinusitis

Introduction: The incidence of chronic rhinosinusitis and its exacerbation has been associated with primary immunodeficiency. This study focuses on investigating the influence of selective immunoglobulin deficiency (IgG or IgA) on the rate and exacerbation of chronic rhinosinusitis.

Methods: This retrospective study examines patients at Beth Israel Deaconess Medical Center who were tested for selective immunoglobulin deficiency, categorizing them into two groups: Group A (normal Ig levels) and Group B (low Ig with selective IgA or IgG deficiency). The study compares rates of chronic rhinosinusitis (CRS), acute rhinosinusitis (ARS), and surgical interventions between the two groups.

Results: A total of 385 patients with IgG or IgA deficiency and 11,133 patients with normal IgA and IgG were included in the study. The rate of CRS was significantly higher in the Ig deficiency group (50, 12.99%) compared to the normal Ig group (529, 4.25%) (P < 0.05). When examining the CRS patients in both groups, there was no statistically significant difference in the number of patients with recurrent ARS (42% vs. 33%, p = 0.2), nor in the average number of ARS attacks (2.28 ± 0.56 vs. 1.41 ± 0.17, p = 0.10). Additionally, there was no difference in the rate of functional endoscopic sinus surgery (14, 28% vs. 125, 24%, p = 0.5).

Conclusions: Individuals with selective IgA or IgG show a higher prevalence of chronic rhinosinusitis. Although surgical interventions and exacerbation rates do not significantly differ, an observable upward trend exists. Identifying underlying factors is crucial for effective treatment, warranting further research with larger patient cohorts to explore the underlying mechanism and appropriate treatment.