title: Antibody response to pneumococcal vaccination in children with chronic or recurrent rhinosinusitis.
abstract: OBJECTIVE
  Although chronic and recurrent rhinosinusitis is prevalent in children, little is known about its causes. Here, we investigated the humoral immunity in children with chronic or recurrent rhinosinusitis.
  
  
  METHODS
  We examined 16 children attending the outpatient clinic at the CHA Bundang Medical Center including 11 boys and 5 girls, aged 3.11 years (mean age, 5.6 years), who had rhinosinusitis for >3 months or >3 times per year. The complete blood count with differential and total serum concentrations of Immunoglobulin (Ig) E, IgA, IgD, IgM, IgG, and IgG subclasses (IgG1, IgG2, IgG3, and IgG4) of all children were measured. All subjects received 23-polysaccharide pneumococcal vaccination (PPV), and the levels of antibodies to 5 serologic types (4, 6B, 14, 18C, and 23F) of pneumococcal capsular polysaccharide antigens were measured before and after vaccination. Post-PPV antibody titers ≥0.35 µg/mL or with a ≥4-fold increase were considered as positive responses.
  
  
  RESULTS
  The titers of IgG, IgA, IgD, and IgM were within normal range in all 16 children, whereas the total IgE concentration was higher than normal in 2 children. IgG1 deficiency was observed in 1 patient and IgG3 deficiency in 3. After PPV, 1 patient failed to respond to all 5 serologic types, 2 failed to respond to 4 serologic types, and 2 failed to respond to 3 serologic types.
  
  
  CONCLUSIONS
  Clinicians should consider the evaluation of humoral immune functions in children with chronic or recurrent rhinosinusitis who do not respond to prolonged antibiotic treatment.
authors.affiliation: Department of Pediatrics, CHA Bundang Medical Center, CHA University, Seongnam, Korea.
authors.forename: Ji Hyeon
authors.initials: JH
authors.lastname: Baek
authors.forename: Hyun Kyong
authors.initials: HK
authors.lastname: Seo
authors.forename: Hye Mi
authors.initials: HM
authors.lastname: Jee
authors.forename: Youn Ho
authors.initials: YH
authors.lastname: Shin
authors.forename: Man Yong
authors.initials: MY
authors.lastname: Han
authors.forename: Eun Sang
authors.initials: ES
authors.lastname: Oh
authors.forename: Hyun Ju
authors.initials: HJ
authors.lastname: Lee
authors.forename: Kyung Hyo
authors.initials: KH
authors.lastname: Kim
keywords: Humoral immune deficiency; Polysaccharide pneumococcal vaccines; Rhinosinusitis
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