Immunologic evaluation of patients with recurrent ear, nose, and throat infections.
OBJECTIVE
In this study, we aimed to study the frequency of possible underlying immunodeficiency responsible for susceptibility to ear, nose, and throat (ENT) infection.


METHODS
One hundred three (72 males and 31 females) consecutive children and adult patients with history of recurrent or chronic ENT infections, referred by otolaryngologists to the Department of Allergy and Clinical Immunology, Children's Medical Center, Tehran University of Medical Sciences (Tehran, Iran), were enrolled to the study from March 2003 to March 2006. For each patient, demographic information and medical histories of any ENT infections were collected by reviewing the patient's records. We measured immunoglobulin isotype concentrations and immunoglobulin (Ig) G subclasses by nephelometry and enzyme-linked immunosorbent assay methods, respectively. Of 103 patients, 75 received unconjugated pneumococcus polyvalent vaccine, and blood samples were taken before and 21 days after vaccination. Specific antibodies against whole pneumococcal antigens were measured using enzyme-linked immunosorbent assay method. Existence of bronchiectasis was confirmed in each patient using high resolution computed tomography scan.


RESULTS
Among 103 patients, 17 (16.5%) patients were diagnosed to have defects in antibody-mediated immunity including 6 patients with immunoglobulin class deficiency (2 common variable deficiency and 4 IgA deficiency), 3 with IgG subclass deficiency (2 IgG2 and 1 IgG3), and 8 with specific antibody deficiency against polysaccharide antigens. In our series, bronchiectasis was detected in 5 cases associated with primary immunodeficiency.


CONCLUSIONS
Long-standing history of ENT infections could be an alarm for ENT infections associated with primary antibody deficiency.
Aghamohammadi
Asghar
A
Department of Pediatrics, Children's Medical Center Hospital, Immunology, Asthma and Allergy Research Institute, Medical Sciences/University of Tehran, Tehran, Iran. aghamohammadi@sina.tums.ac.ir
Moin
Mostafa
M
Karimi
Alireza
A
Naraghi
Mohsen
M
Zandieh
Fariborz
F
Isaeian
Anna
A
Tahaei
Amir
A
Talaei-Khoei
Mojtaba
M
Kouhi
Ali
A
Abdollahzade
Sina
S
Pouladi
Nima
N
Heidari
Golnaz
G
Amirzargar
Ali Akbar
AA
Rezaei
Nima
N
Sazgar
Amir Arvin
AA
D000293:Adolescent; D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D017098:IgA Deficiency / Q000175:diagnosis / Q000453:epidemiology; D017099:IgG Deficiency / Q000175:diagnosis / Q000453:epidemiology; D007153:Immunologic Deficiency Syndromes / Q000175:diagnosis* / Q000453:epidemiology; D015994:Incidence; D007492:Iran / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015166:Monitoring, Immunologic; D010033:Otitis Media / Q000453:epidemiology / Q000276:immunology*; D010612:Pharyngitis / Q000453:epidemiology / Q000276:immunology*; D012008:Recurrence; D012220:Rhinitis / Q000453:epidemiology / Q000276:immunology*; D018570:Risk Assessment; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D055815:Young Adult