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10.1016/j.jaip.2014.09.022

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suck abstract from ncbi


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pmid25609325      J+Allergy+Clin+Immunol+Pract 2015 ; 3 (2): 236-42
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  • Clinical Characteristics of Adults with Chronic Rhinosinusitis and Specific Antibody Deficiency #MMPMID25609325
  • Kashani S; Carr TF; Grammer LC; Schleimer RP; Hulse KE; Kato A; Kern RC; Conley DB; Chandra RK; Tan BK; Peters AT
  • J Allergy Clin Immunol Pract 2015[Mar]; 3 (2): 236-42 PMID25609325show ga
  • Background: Specific antibody deficiency (SAD) involves a deficient response to a polysaccharide vaccine in the setting of normal IgG levels and chronic infections. Patients with chronic rhinosinusitis (CRS) are often evaluated for SAD. There is limited data describing patients with CRS and SAD. Objective: 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 immunoglobulin levels and pre- and post-antibody titers to a pneumococcal polysaccharide vaccine (PPV). Results: 14 pneumococcal serotypes were determined in 239 subjects from 2002?2009. 64 subjects had adequate protective titers of 1.3 ?g/mL or higher in 7 or more serotypes out of the 14 serotypes checked. 56 (23%) had less than 7 protective titers post-PPV and were diagnosed with SAD. 119 subjects had an adequate response to the vaccine with 7 or more serotypes being higher than 1.3 ?g/mL (>50% response) and were characterized as ?responders?. Subjects with SAD received more antibiotic courses relative to responders in the two years following immunization (3.19 ± 2.64 vs. 2.19 ± 2.24, p<0.05). Ten of 56 subjects (17.9%) with SAD received immunoglobulin (Ig) replacement therapy. Subjects receiving Ig had fewer numbers of protective pneumococcal titers post PPV and had more pneumonia (40.0%) versus subjects with SAD not receiving Ig (10.9%). Conclusions: Of 239 CRS patients 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.
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