2192 Computed Tomography Findings Consistent with Rhinosinusitis, Clinical Correlation and Quality of Life in Patients with Common Variable Immunodeficiency. Original Article

Monday, 5 December 2011: 13:15 - 13:30
Isla Mujeres (Cancún Center)

Elizabeth Mendieta, Doctors in training , Allergy & Clinical Immunology, Specialty Hospital Medical Center XXI Century, Mexico, Mexico City, Author, Mexico City , Mexico

Leonel Gerardo Del Rivero, MD , Allergy and Immunology , MD, Mexico City , Mexico

Background:

Common Variable Immunodeficiency (CVID) is a clinical syndrome characterized by a reduction and / or absence of IgG, IgM and IgA to respiratory tract infections and / or gastrointestinal can be associated with lymphoproliferative and autoimmune processes. The infections  found in paranasal sinuses are an important cause of morbidity and generate deterioration in the quality of life in this patient population. Multidetector Computed Tomography (MDCT) of the sinuses is the Gold standard for diagnosis of rhinosinusitis . The Rhinosinusitis disability index (RSDI) developed by Benninger and Senior, evaluates the quality of life in patients with nasal disease, including rhinosinusitis. 

Methods:

Fourteen patients were included with a definitive diagnosis of CVID according to the diagnostic criteria of the European Society for Immunodeficiencies in each of the patients were evaluated: 1. The diagnostic criteria according to the European Consensus on Rhinosinusitis and nasal polyposis (EPOS 2007) 2. MDCT  of Sinuses. 3. Each patient answered the questionnaire of  RSDI .

Correlation was calculated using Spearman Ro (rs) 

Results:

Ten patients were female (71.4%) and four were male (28.5%). The average age was 34 years. In eight patients (57%) received the diagnosis of rhinosinusitis. The maxillary sinus was affected in five patients find us (45%), followed by ethmoid sinus (36%), frontal sinus and sphenoid was affected in 9% of patients. The correlation between clinical symptoms and MDCT study was consistent with rhinosinusitis rs = 0.84 . The correlation between the clinical diagnosis, CT and rhinosinusitis disability index was rs = 0.71 .  In  five of the fourteen patients studied showed no clinical symptoms of rinosinuistis, but in MDCT of the sinuses if they showed data compatible with the disease. Three of these patients showed bilateral location (69%) and in one patient the findings were found in 3 sinuses frontal, ethmoid and maxillary.


Conclusions:

The sinus infection is a major cause of morbidity in patients with CVID. As in the initial study should include a CT scan of paranasal sinuses for proper assessment and timely diagnosis. 

Bibliography: Deane S, Selmi C , Naguwa S et a. Common Variable Immunodeficiency: Etiological and Treatment Issues . Review . Int Arch Allergy Immunol 2009;150:311–324