Abstract
Background: Common variable immunodeficiency (CVID) is one of the most common antibody deficiencies in adults. The prevalence of respiratory infections have been reported in 75% vs 2-16% in general population. Chronic rhinosinusitis is an inflammatory disease affecting paranasal sinuses and nose.
Objective: To show the prevalence of chronic rhinosinusitis, affected sinus and severity by CT scan in adult patients with CVID.
Material and method: A descriptive, observational and cross sectional study was made including 21 patients with CVID. Paranasal sinus CT scan was performed to all patients and was assessed by Otolaryngologist. The chronic rhinosinusitis severity was assessed with Lund-Mackay score.
Results: Out of 21 patients, 15 were women (71.5%); average age was of 40 years (±13), 12 patients had chronic rhinosinusitis; according to Lund-Mackay score, 2 (17.8%) had the severe form, 3 (7.7%) had the moderate and 7 (54.5%) the mild one. The most affected sinus was bilateral maxilar sinus (n=7, 33%), ethmoid (n=6, 26%), unilateral maxilar sinus (n=4, 19%), frontal and sphenoid (n=3, 13%) each one. The following anatomical variations were found: deviated septum (n=6, 28.5%), maxillary septum (n=3, 14.2%), bilateral maxillary sinus hypoplasia (n=2, 10%), unilateral concha bullosa (n=2, 10%) and pneumatized Agger Nasi cell (n=1, 4.7%).
Conclusions: 52% of patients with common variable immunodeficiency (CVID) presented chronic rhinosinusitis, 58% mild according to Lund- Mackay score; the main affected sinus was bilateral maxillary sinus (33%). Due to the prevalence of chronic rhinosinusitis in patients with common variable immunodeficiency, paranasal sinus CT scan should be performed in all patients to establish diagnosis and treatment.
References
Coria R E, Espinosa PS, y col. Panorama epidemiológico de las inmunodeficiencia primarias en México. Rev Alerg Mex 2010;57:159-163.
Mendieta-Flores E, Segura-Méndez NH y col. Rinosinusitis y su impacto en la calidad de vida en pacientes con inmunodeficiencia común variable. Rev Alerg Mex 2012;59:60-64.
Fokkens W, Lund JV, et al. EPOS 2012: European position paper on rhinosinusitis and nasal polyps 2012. International Rhinologic Society 2012;50.
Slavin RG, Kaliner MA, Kennedy DW, Virant FS, et al. The diagnosis and management of sinusitis: A practice parameter update. J Allergy Clin Immunol 2005;116.
Hamilos DL. Chronic rhinosinusitis: Epidemiology and medical management. J Allergy Clin Inmmunol 2011;128:693-707.
Chow AW, Benninger MS, et al. IDSA clinical practice guideline for acute bacterial rhinosinusitis in children and adults. Clin Infect Dis 2012;54:e72-e112.
Dorberker AR, Mogica MD y col. Características clínicas y terapéuticas de pacientes con inmunodeficiencia común variable en dos hospitales de tercer nivel de atención de la Ciudad de México. Rev Alerg Mex 2013;60:26-30.
Aghamohammadi A, Tavassoli M. Infectious and noninfectious complications among undiagnosed patients with common variable immunodeficiency. Iran J Pediatr 2009;19:367-375.
Kainulainen L, Suonpaa J, et al. Bacteria and viruses in maxillary sinuses of patients with primary hypogammaglobulinemia. Arch Otolaryngol Head Neck Surg 2007;133:597-602.
Messerklinger W. Endoscopy of the nose. Baltimore: Urban & Schwarzenberg, 1978;1-18.
Vargas AA, Ascencio VM y col. Correlación clinicorradiológica en sinusitis crónica. Cir Ciruj 2003;71:359-362.
Grazia KJ, Miranga GG y col. Prevalencia de variantes anatómicas nasosinusales: importancia en el informe radiológico y en la cirugía endoscópica funcional. Rev Chil Radiología 2014;20:5-12.
Garzón H, Oróstegui V. Sinusitis crónica y prevalencia de concha bullosa. Repertorio de Medicina y Cirugía 2005;14.
Gardía de Hombre A. Hipoplasia de seno maxilar: caso clínico. Rev Otorrinolaringol Cir Cab Cue 2002;62:42-46.
Domínguez NJ, Álvarez GY. Hipoplasia de seno maxilar en un paciente octagenario: presentación de un caso. Gaceta Médica Espirituana 2012;14.
Álvarez GY, García ARM. Rinosinusitis crónica. Correlación clínica, endoscópica y tomográfica. 2007-2009. ORL Aragón 2011;14:6-10.
Araujo NS, Elias BE. A new score for tomographic opacification of paranasal sinuses in children. Braz J Otorhinolaryngol 2010;76:491-498.
Jy Chen J, Lion Chem D, et al. The Lund-Mackay score for adult head and neck computed tomography. J Radiol Sci 2011;36:203-208.
Lund VJ, Kennedy DW. Staging for rinosinusitis. Otolaryngol Head Neck Surg 1997;117:35-40.
Maestre FL, Galan GS y col. Los septos del seno maxilar: Una revisión sistemática. Medicina oral, patología oral y cirugía bucal 2010;15:120-124.

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Copyright (c) 2015 Revista Alergia México