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.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 236-242 |
| Number of pages | 7 |
| Journal | Journal of Allergy and Clinical Immunology: In Practice |
| Volume | 3 |
| Issue number | 2 |
| DOIs | |
| State | Published - Mar 1 2015 |
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Keywords
- Chronic rhinosinusitis
- Immunoglobulin replacement therapy
- Pneumococcal antibody concentration
- Primary immunodeficiency
- Specific antibody deficiency
ASJC Scopus subject areas
- Immunology and Allergy
Cite this
}
Clinical Characteristics of Adults With Chronic Rhinosinusitis and Specific Antibody Deficiency. / Kashani, Sara; Carr, Tara F.; Grammer, Leslie C.; Schleimer, Robert P.; Hulse, Kathryn E.; Kato, Atsushi; Kern, Robert C.; Conley, David B.; Chandra, Rakesh K.; Tan, Bruce K.; Peters, Anju T.
In: Journal of Allergy and Clinical Immunology: In Practice, Vol. 3, No. 2, 01.03.2015, p. 236-242.Research output: Contribution to journal › Article
TY - JOUR
T1 - Clinical Characteristics of Adults With Chronic Rhinosinusitis and Specific Antibody Deficiency
AU - Kashani, Sara
AU - Carr, Tara F.
AU - Grammer, Leslie C.
AU - Schleimer, Robert P.
AU - Hulse, Kathryn E.
AU - Kato, Atsushi
AU - Kern, Robert C.
AU - Conley, David B.
AU - Chandra, Rakesh K.
AU - Tan, Bruce K.
AU - Peters, Anju T.
PY - 2015/3/1
Y1 - 2015/3/1
N2 - 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.
AB - 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.
KW - Chronic rhinosinusitis
KW - Immunoglobulin replacement therapy
KW - Pneumococcal antibody concentration
KW - Primary immunodeficiency
KW - Specific antibody deficiency
UR - http://www.scopus.com/inward/record.url?scp=84924108461&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84924108461&partnerID=8YFLogxK
U2 - 10.1016/j.jaip.2014.09.022
DO - 10.1016/j.jaip.2014.09.022
M3 - Article
C2 - 25609325
AN - SCOPUS:84924108461
VL - 3
SP - 236
EP - 242
JO - Journal of Allergy and Clinical Immunology: In Practice
JF - Journal of Allergy and Clinical Immunology: In Practice
SN - 2213-2198
IS - 2
ER -