title: Antibody deficiency in chronic rhinosinusitis: epidemiology and burden of illness.
abstract: BACKGROUND
  A subset of patients with chronic rhinosinusitis (CRS) has refractory disease. The risk factors for refractory CRS include atopy, a disrupted mucociliary transport system, medical conditions affecting the sinonasal tract mucosa, and immunodeficiency.
  
  
  METHODS
  We review four primary immunodeficiencies reported in individuals with CRS: common variable immune deficiency (CVID), selective IgA deficiency, IgG subclass deficiency, and specific antibody deficiency. We also review treatment options for individuals with both CRS and  a concomitant immune defect.
  
  
  RESULTS
  There is a high prevalence of CRS in individuals with CVID and selective IgA deficiency. While many reports describe IgG subclass deficiency in individuals with CRS, the clinical relevance of this is unclear. Specific antibody deficiency  may play a more significant role in the pathogenesis of refractory CRS.
  
  
  CONCLUSIONS
  Screening for a primary immunodeficiency should be part of the diagnostic workup of refractory CRS, as its identification may allow for more effective long-term therapeutic options.
authors: Division of Allergy-Immunology, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA.
authors: Christopher J
authors: CJ
authors: Ocampo
authors: Anju T
authors: AT
authors: Peters
mesh_terms: D000906:Antibodies / Q000097:blood; D002908:Chronic Disease; D017281:Cost of Illness; D017048:Health Care Costs; D006801:Humans; D007153:Immunologic Deficiency Syndromes / Q000191:economics* / Q000453:epidemiology*; D015995:Prevalence; D012220:Rhinitis / Q000191:economics* / Q000453:epidemiology* / Q000276:immunology; D012306:Risk; D012852:Sinusitis / Q000191:economics* / Q000453:epidemiology* / Q000276:immunology
chemical_list: D000906:Antibodies