BACKGROUND: Rhinosinusitis is highly prevalent in patients with common variable immunodeficiency (CVID), and probably allergic rhinitis (AR) may be masked by a history of repeated respiratory infections. The diagnosis of AR is based on the patient's symptoms and detection of specific immunoglobulin E (IgE) to aeroallergens. This study was designed to identify rhinitis of probable allergic cause in patients with CVID. METHODS: This study included 72 adult CVID patients. The patients were divided into three groups according to their history: suggestive of AR, nonallergic rhinitis, and without rhinitis. They were tested for total and specific IgE (in vivo and in vitro). RESULTS: The patients' mean age was 38.2 years. A history of chronic rhinitis was observed in 59 (81.9%) of the cases, 31 of which (43%) had a history suggestive of AR. Patients with a history of rhinitis (whether allergic or nonallergic) presented an earlier onset of symptoms and diagnosis of CVID. Total IgE was undetectable in 86.1% of patients. AR was confirmed by detection of specific IgE to aeroallergens in only 5.6% of the patients. CONCLUSION: In CVID patients, chronic rhinitis may be allergic, because many have personal and family histories suggestive of atopy. However, in this study, allergy was confirmed by specific IgE detection in only 5.6% of cases. CVID patients with a history suggestive of AR commonly present negative results on traditional testing, so additional experiments may be necessary. One suggestion for the investigation of AR in CVID patients would be nasal provocation with the most prevalent allergens.
BACKGROUND: Rhinosinusitis is highly prevalent in patients with common variable immunodeficiency (CVID), and probably allergic rhinitis (AR) may be masked by a history of repeated respiratory infections. The diagnosis of AR is based on the patient's symptoms and detection of specific immunoglobulin E (IgE) to aeroallergens. This study was designed to identify rhinitis of probable allergic cause in patients with CVID. METHODS: This study included 72 adult CVIDpatients. The patients were divided into three groups according to their history: suggestive of AR, nonallergic rhinitis, and without rhinitis. They were tested for total and specific IgE (in vivo and in vitro). RESULTS: The patients' mean age was 38.2 years. A history of chronic rhinitis was observed in 59 (81.9%) of the cases, 31 of which (43%) had a history suggestive of AR. Patients with a history of rhinitis (whether allergic or nonallergic) presented an earlier onset of symptoms and diagnosis of CVID. Total IgE was undetectable in 86.1% of patients. AR was confirmed by detection of specific IgE to aeroallergens in only 5.6% of the patients. CONCLUSION: In CVIDpatients, chronic rhinitis may be allergic, because many have personal and family histories suggestive of atopy. However, in this study, allergy was confirmed by specific IgE detection in only 5.6% of cases. CVIDpatients with a history suggestive of AR commonly present negative results on traditional testing, so additional experiments may be necessary. One suggestion for the investigation of AR in CVIDpatients would be nasal provocation with the most prevalent allergens.
Authors: Francisco A Bonilla; Isil Barlan; Helen Chapel; Beatriz T Costa-Carvalho; Charlotte Cunningham-Rundles; M Teresa de la Morena; Francisco J Espinosa-Rosales; Lennart Hammarström; Shigeaki Nonoyama; Isabella Quinti; John M Routes; Mimi L K Tang; Klaus Warnatz Journal: J Allergy Clin Immunol Pract Date: 2015-11-07
Authors: Heather Hartman; Karrie Schneider; Mary Hintermeyer; Mary Bausch-Jurken; Ramsay Fuleihan; Kathleen E Sullivan; Charlotte Cunningham-Rundles; Francisco A Bonilla; James Verbsky; John Routes Journal: J Clin Immunol Date: 2016-11-22 Impact factor: 8.317
Authors: L Klimek; A Chaker; C Matthias; A Sperl; P Gevaert; P Hellings; B Wollenberg; M Koennecke; J Hagemann; J Eckrich; S Becker Journal: HNO Date: 2019-09 Impact factor: 1.284
Authors: Monica G Lawrence; Thamiris V Palacios-Kibler; Lisa J Workman; Alexander J Schuyler; John W Steinke; Spencer C Payne; Emily C McGowan; James Patrie; Ramsay L Fuleihan; Kathleen E Sullivan; Patricia L Lugar; Camellia L Hernandez; Douglas E Beakes; James W Verbsky; Thomas A E Platts-Mills; Charlotte Cunningham-Rundles; John M Routes; Larry Borish Journal: J Clin Immunol Date: 2018-02-17 Impact factor: 8.317