CHRONIC SINUSITIS AS A MANIFESTATION OF PRIMARY IMMUNODEFICIENCY IN ADULTS

Twenty-three adult patients evaluated at a university medical center f or severe refractory sinusitis were found to have a primary immunodefi ciency on the basis of total immunoglobulin, IgG subclass, and vaccine response determinations. The most common finding was IgG3 deficiency with antibody hyporesponsiveness to pneumococcal vaccine. Treatment op tions included prophylactic antibiotics and aggressive management of a ssociated allergies with intravenous immunoglobulin reserved for sever ely affected patients who failed more conservative therapy.