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.
N1 - Funding Information:
Conflicts of interest: T.F. Carr is employed by the University of Arizona and has received research support from NHLBI AsthmaNet. L.C. Grammer has received research support and travel support from the National Institutes of Health; has received a grant from the Bazley Foundation; has received consultancy fees from Astellas Pharmaceuticals; is employed by Northwestern University and Northwestern Medical Faculty Foundation; has received research support from the Food Allergy Network and S&C Electric; has received lecture fees from the AAAAI, Mount Sinai; and receives royalties from Lippincott, UpToDate, BMJ, and Elsevier. R.P. Schleimer has received research support from the National Institutes of Health; has received consultancy fees from Intersect ENT, GlaxoSmithKline, Allakos, Aurasense, and Merck; and owns stock in Allakos, Aurasense, and Biomarck. K.E. Hulse has received research support from the National Institutes of Health. A. Kato has received research grants from the National Institutes of Health ( R01 AI104733 , R21 HL113913 ). A.T. Peters has received lecture fees from Baxter. B.K. Tan has received research support from the National Institutes of Health (grant: K23DC012067 , U19AI106683 ) and the Triological Society-American College of Surgeons; has received consultancy fees from Acclarent Inc.; and has received travel support from the Foundation for Innovation, Education, and Research in Otorhinolaryngology. The rest of the authors declare that they have no relevant conflicts. Original Article
Publisher Copyright:
© 2014 American Academy of Allergy, Asthma & Immunology.
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
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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 -
