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ENT manifestations in Iranian patients with primary antibody deficiencies

Published online by Cambridge University Press:  07 April 2017

A Aghamohammadi*
Affiliation:
Department of Allergy and Clinical Immunology, Children's Medical Center, Immunology, Asthma and Allergy Research Institute, Tehran University of Medical Sciences, Tehran, Iran
K Moazzami
Affiliation:
Department of Allergy and Clinical Immunology, Children's Medical Center, Immunology, Asthma and Allergy Research Institute, Tehran University of Medical Sciences, Tehran, Iran
N Rezaei
Affiliation:
Department of Allergy and Clinical Immunology, Children's Medical Center, Immunology, Asthma and Allergy Research Institute, Tehran University of Medical Sciences, Tehran, Iran
A Karimi
Affiliation:
Department of Ear, Nose, and Throat, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
M Movahedi
Affiliation:
Department of Allergy and Clinical Immunology, Children's Medical Center, Immunology, Asthma and Allergy Research Institute, Tehran University of Medical Sciences, Tehran, Iran
M Gharagozlou
Affiliation:
Department of Allergy and Clinical Immunology, Children's Medical Center, Immunology, Asthma and Allergy Research Institute, Tehran University of Medical Sciences, Tehran, Iran
S Abdollahzade
Affiliation:
Department of Allergy and Clinical Immunology, Children's Medical Center, Immunology, Asthma and Allergy Research Institute, Tehran University of Medical Sciences, Tehran, Iran
N Pouladi
Affiliation:
Department of Allergy and Clinical Immunology, Children's Medical Center, Immunology, Asthma and Allergy Research Institute, Tehran University of Medical Sciences, Tehran, Iran
A Kouhi
Affiliation:
Department of Allergy and Clinical Immunology, Children's Medical Center, Immunology, Asthma and Allergy Research Institute, Tehran University of Medical Sciences, Tehran, Iran
M Moin
Affiliation:
Department of Allergy and Clinical Immunology, Children's Medical Center, Immunology, Asthma and Allergy Research Institute, Tehran University of Medical Sciences, Tehran, Iran
*
Address for correspondence: Asghar Aghamohammadi, Children's Medical Center Hospital, No 62, Dr Gharib St, Keshavarz Blvd, PO Box: 14185-863, Tehran 14194, Iran. Fax: +98 21 6642 89 95 E-mail: aghamohammadi@sina.tums.ac.ir

Abstract

Objective:

One hundred and nine patients with primary antibody deficiencies were selected in order to determine the frequency of ENT complications.

Method:

Demographic information and ENT medical histories were collected for each patient. Duration of study for each patient was divided into two periods of before diagnosis and after diagnosis and the initiation of treatment.

Results:

Eighty-two of 109 patients (75.2 per cent) experienced ENT infections during the course of the disease (63: otitis media, 75: sinusitis and nine: mastoiditis). At the time of diagnosis, 52 (47.7 per cent) out of 109 patients presented with an ENT symptom. The frequencies of episodes were 27 for sinusitis and 25 for otitis media (one complicated with mastoiditis). After immunoglobulin replacement therapy the incidence of otitis media was reduced from 1.75 before treatment to 0.39 after treatment per patient per year (p = 0.008). The incidence of sinusitis also significantly decreased from 2.38 to 0.78 (p value = 0.011).

Conclusion:

ENT infections are common medical problems in primary antibody deficiency patients. Persistent and recurrent ENT infections should be suspected as originating from a possible underlying immunodeficiency.

Type
Main Article
Copyright
Copyright © JLO (1984) Limited 2007

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References

1 Notarangelo, L, Casanova, JL, Conley, ME, Chapel, H, Fischer, A, Puck, J et al. Primary immunodeficiency diseases: an update from the International Union of Immunological Societies Primary Immunodeficiency Diseases Classification Committee Meeting in Budapest, 2005. J Allergy Clin Immunol 2006;117:883–96CrossRefGoogle ScholarPubMed
2 Aghamohammadi, A, Moein, M, Farhoudi, A, Pourpak, Z, Rezaei, N, Abolmaali, K et al. Primary immunodeficiency in Iran: First report of the national registry of PID in children and adults. J Clin Immunol 2002;22:375–80CrossRefGoogle Scholar
3 Tsukada, S, Saffran, DC, Rawlings, DJ, Parolini, O, Allen, RC, Klisak, I et al. Deficient expression of a B cell cytoplasmic tyrosine kinase in human X-linked agammaglobulinemia. Cell 1993;72:279–90CrossRefGoogle Scholar
4 Aghamohammadi, A, Fiorini, M, Moin, M, Parvaneh, N, Teimourian, S, Yeganeh, M et al. Clinical, immunological and molecular characteristics of 37 Iranian patients with X-Linked agammaglobulinemia. Int Arch Allergy Immunol 2006;141:408–14CrossRefGoogle ScholarPubMed
5 Ballow, M. Primary immunodeficiency disorders: antibody deficiency. J Allergy Clin Immunol 2002;109:581–91CrossRefGoogle ScholarPubMed
6 Hermaszewski, RA, Webster, AD. Primary hypogammaglobulinaemia: a survey of clinical manifestations and complications. Q J Med 1993;86:3142Google ScholarPubMed
7 Cunningham-Rundles, C, Bodian, C. Common variable immunodeficiency: clinical and immunological features of 248 patients. Clin Immunol 1999;92:3448CrossRefGoogle ScholarPubMed
8 Pettit, SJ, Bourne, H, Spickett, GP. Survey of infection in patients receiving antibody replacement treatment for immune deficiency. J Clin Pathol 2002;55:577–80CrossRefGoogle ScholarPubMed
9 Plebani, A, Soresina, A, Rondelli, R, Amato, GM, Azzari, C, Cardinale, F et al. Clinical, immunological, and molecular analysis in a large cohort of patients with X-linked agammaglobulinemia: An Italian Multicenter Study. Clin Immunol 2002;104:221–30CrossRefGoogle Scholar
10 Galicia, G, Betancourt, MA, Canales, LE, Cristerna, L. Ear, nose, and throat manifestations in patients with primary immunodeficiencies [in Spanish]. Rev Alerg Mex 1999;46:108–19Google ScholarPubMed
11 Blore, J, Haeney, MR. Primary antibody deficiency and diagnostic delay. BMJ 1989;298:516–17CrossRefGoogle ScholarPubMed
12 Conley, ME, Notarangelo, LD, Etzioni, A. Diagnostic criteria for primary immunodeficiencies. Clin Immunol 1999;93:190–7CrossRefGoogle ScholarPubMed
13 Benninger, MS, Ferguson, BJ, Hadley, JA, Hamilos, DL, Jacobs, M, Kennedy, DW et al. Adult chronic rhinosinusitis: definitions, diagnosis, epidemiology, and pathophysiology. Otolaryngol Head Neck Surg 2003;129:S132CrossRefGoogle ScholarPubMed
14 Pichichero, ME, Casey, JR. Otitis media. Expert Opin Pharmacother 2002;3:1073–90Google ScholarPubMed
15 Morris, PS. Management of otitis media in a high risk population. Aust Fam Physician 1998;27:1021–9Google ScholarPubMed
16 Lanza, DC, Kennedy, DW. Adult rhinosinusitis defined. Otolaryngol Head Neck Surg 1997;117:S17CrossRefGoogle ScholarPubMed
17 Meltzer, EO, Hamilos, DL, Hadley, JA, Lanza, DC, Marple, BF, Nicklas, RA et al. Rhinosinusitis: establishing definitions for clinical research and patient care. J Allergy Clin Immunol 2004;114:155212CrossRefGoogle ScholarPubMed
18 Roland, PS. Chronic suppurative otitis media: a clinical overview. Ear Nose Throat J 2002;81:810Google ScholarPubMed
19 Bernatowska, E, Mikoluc, B, Krzeski, A, Piatosa, B, Gromek, I. Chronic rhinosinusitis in primary antibody immunodeficient patients. Int J Pediatr Otorhinolaryngol 2006;70:1587–92CrossRefGoogle ScholarPubMed
20 Karlsson, G, Petruson, B, Bjorkander, J, Hanson, LA. Infections of the nose and paranasal sinuses in adult patients with immunodeficiency. Arch Otolaryngol 1985;111:290–3CrossRefGoogle ScholarPubMed
21 Cooney, TR, Huissoon, AP, Powell, RJ, Jones, NS. Investigation for immunodeficiency in patients with recurrent ENT infections. Clin Otolaryngol Allied Sci 2001;26:184–8CrossRefGoogle ScholarPubMed
22 Shapiro, GG, Virant, FS, Furukawa, CT, Pierson, WE, Bierman, CW. Immunologic defects in patients with refractory sinusitis. Pediatrics 1991;87:311–16CrossRefGoogle ScholarPubMed
23 Favre, O, Leimgruber, A, Nicole, A, Spertini, F. Intravenous immunoglobulin replacement prevents severe and lower respiratory tract infections, but not upper respiratory tract and non-respiratory infections in common variable immune deficiency. Allergy 2005;60:385–90CrossRefGoogle Scholar