IMMUNOLOGICAL DEFECTS IN PATIENTS WITH CHRONIC RECURRENT SINUSITIS - DIAGNOSIS AND MANAGEMENT

Twenty patients with chronic refractory sinusitis or rhinitis were ide ntified to have immune defects on the basis of total immunoglobulin le vel, immunoglobulin G subclass, and vaccine response, Eight patients w ere immunoglobulin A deficient, five had low immunoglobulin levels wit h vaccine hyporesponse, and four had low immunoglobulin revels with no rmal vaccine responses. Three subjects showed isolated immunoglobulin G1 deficiency, Demographic variables such as age, sex, infection patte rn, and any other related disorders were studied retrospectively, whic h may have contributed to the diagnosis, An immunologic screen was ess ential for the diagnosis of immunodeficiency in these patients, Treatm ent options included prophylactic antibiotics, management of associate d allergies, functional endoscopic sinus surgery, and replacement ther apy with immunoglobulin in selected patients,