Characterization of specific antibody deficiency in adults with medically refractory chronic rhinosinusitis

Tara F. Carr, Alan P. Koterba, Rakesh Chandra, Leslie C. Grammer, David B. Conley, Kathleen E. Harris, Robert Kern, Robert P. Schleimer, Anju T. Peters*

*Corresponding author for this work

Research output: Contribution to journalArticle

50 Scopus citations


Background: Specific antibody deficiency may predispose patients to recurrent respiratory tract infections. There is limited literature assessing specific antibody deficiency in chronic rhinosinusitis (CRS). This study evaluated the role of specific antibody deficiency in patients with CRS who have failed medical therapy. Methods: We performed a retrospective chart review of patients with CRS who underwent functional endoscopic sinus surgery and had prior assessment for humoral immunodeficiency. Each patient's record was reviewed for serum quantitative immunoglobulin G (IgG) and IgA and anti-Streptococcus pneumoniae antibody titers measured at baseline and 6 weeks postvaccination with the 23-valent unconjugated pneumococcal vaccine. Clinical characteristics, including asthma, atopy, and nasal polyps, were recorded. Results: Of the 129 CRS patients who met inclusion criteria, 93 (72%) had low baseline antipneumococcal titers. Fifteen (11.6%) patients were diagnosed with specific antibody deficiency based on an inadequate response to the pneumococcal polysaccharide vaccine. The group of patients with specific antibody deficiency had significantly lower serum IgA levels when compared with those patients with normal preimmunization titers (138 ± 67.3 versus 330 ± 356; p < 0.05). Patients with specific antibody deficiency had a significantly lower number of preimmunization protective antipneumococcal titers when compared with vaccine responders (1.41 versus 2.72; p < 0.0005). Conclusion: This retrospective study indicates that patients with medically refractory CRS may have a high prevalence of low preimmunization antipneumococcal titers and specific antibody deficiency. Furthermore, lower serum IgA levels identified in these specific antibody deficiency patients suggests that a prospective study to further characterize this relationship is warranted.

Original languageEnglish (US)
Pages (from-to)241-244
Number of pages4
JournalAmerican Journal of Rhinology and Allergy
Issue number4
StatePublished - Jul 2011

ASJC Scopus subject areas

  • Immunology and Allergy
  • Otorhinolaryngology

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