Reduced immunoglobulin M is associated with sinus mucosal thickening, osteitis and sinus surgery in patients with common variable immunodeficiency.
BACKGROUND
Although common variable immunodeficiency (CVID) is associated with sinopulmonary disease, there are no previous systematic evaluations comparing computed tomographic (CT) sinus imaging with immunoglobulin measurements in patients with this condition.


METHODS
We performed a retrospective review by a blinded observer using the Lund-Mackay numerical scoring scale as well as a visual scale for remodeling changes in the paranasal sinus bone on CT scans in CVID patients.


RESULTS
The sinus CT scans of 19 subjects (9 males, 10 females; median age at diagnosis 34 years) are described. There was an inverse relationship between serum IgM and sinus mucosal thickening as described by the Lund-Mackay scale (R = -0.6398; p = 0.0032). Osteitis of the paranasal sinus bone was almost exclusively found in patients with a reduced serum IgM level of less than 25 mg/dl (p = 0.0074).


CONCLUSIONS
This is the first study to show that sinus mucosal thickening on CT in patients with CVID is inversely related to serum IgM levels.
Hagan
John B
JB
Department of Medicine, Division of Allergic Diseases, Mayo Clinic and Foundation, Rochester, Minn., USA.
Park
Miguel A
MA
Kita
Hirohito
H
Campeau
Norbert G
NG
D000293:Adolescent; D000328:Adult; D017074:Common Variable Immunodeficiency / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000276:immunology; D005260:Female; D006801:Humans; D007075:Immunoglobulin M / Q000097:blood*; D008297:Male; D008875:Middle Aged; D009092:Mucous Membrane / Q000000981:diagnostic imaging*; D009297:Nasal Mucosa / Q000000981:diagnostic imaging; D010000:Osteitis / Q000175:diagnosis / Q000000981:diagnostic imaging*; D010256:Paranasal Sinuses / Q000000981:diagnostic imaging / Q000601:surgery*; D011859:Radiography; D012852:Sinusitis / Q000175:diagnosis / Q000000981:diagnostic imaging*; D055815:Young Adult
D007075:Immunoglobulin M