Several studies have shown a high prevalence of immunoglobulin deficiencies in patients with chronic sinus infections. The reported prevalence of chronic sinus infections in industrialized countries is 11%-14%. Chronic sinus infections can be due to multiple causes, including, allergies, anatomical malformations,and local secretory or systemic immunoglobulin deficiencies. The most frequent immunoglobulin deficiencies are IgG subclass deficiencies, with an estimated prevalence of 2-20%; vaccine specific antibody deficiencies, selective IgA deficiency; unspecified IgG deficiency; rare selective IgM deficiency; and common variable immunodeficiency (CVID). https://allergylosangeles.com/allergy-blog/understanding-common-variable-immune-deficiency-cvid/
For symptomatic immunogloblulin deficiencies, early antibiotic treatment and preventive intravenous or subcutaneous immunoglobulin substitution therapy are available. However, many patients with chronic sinus infections go undiagnosed with immune deficiencies. Patients with an untreated immunoglobulin deficiency can present with persistent chronic sinus infections despite medication and surgical management.
A recent study published in the Journal of Allergy and Clinical Immunology reviewed patients who had chronic sinus infections and whether or not they had immunoglobulin deficiencies, notably IgG, IgG subclasses, IgA and IgM deficiencies and CVID.
The results showed that IgG, IgA and IgM deficiencies in 13% of patients with recurrent chronic sinusitis and 23% of patients with difficult to treat chronic sinusitis. The prevalence of of IgG subclass deficiency and specific antibody deficiency was increased in patients with chronic sinusitis as was the prevalence of respiratory allergies.
The conclusion of the study was that immunoglobulin deficiency is a frequent condition in patients with chronic sinusitis. An ever higher prevalence of allergy was observed in patients with chronic sinusitis. Therefore an immune work up and an accurate allergy diagnostic work up is strongly recommended in these patients to provide specific treatment.
If you have recurrent sinus infections, you should be evaluated by a board certified allergist and immunologist. Unnecessary and ineffective surgical procedures can be avoided because patients with difficult to treat chronic sinusitis have an average of 3 sinus surgeries before being assessed for antibody deficiencies.