prevalence, location and tomographic severity of chronic rhinosinusitis in adult patients with common variable immunodeficiency

Background: Common variable immunodeficiency (CVID) is one of the most common antibody deficiencies in adults. The prevalence of respiratory infections have been reported in 75% vs 2-16% in general population. Chronic rhinosinusitis is an inflammatory disease affecting paranasal sinuses and nose. Objective: To show the prevalence of chronic rhinosinusitis, affected sinus and severity by CT scan in adult patients with CVID. Material and method: A descriptive, observational and cross sectional study was made including 21 patients with CVID. Paranasal sinus CT scan was performed to all patients and was assessed by Otolaryngologist. The chronic rhinosinusitis severity was assessed with Lund-Mackay score. Results: Out of 21 patients, 15 were women (71.5%); average age was of 40 years (±13), 12 patients had chronic rhinosinusitis; according to Lund-Mackay score, 2 (17.8%) had the severe form, 3 (7.7%) had the moderate and 7 (54.5%) the mild one. The most affected sinus was bilateral maxilar sinus (n=7, 33%), ethmoid (n=6, 26%), unilateral maxilar sinus (n=4, 19%), frontal and sphenoid (n=3, 13%) each one. The following anatomical variations were found: deviated septum (n=6, 28.5%), maxillary septum (n=3, 14.2%), bilateral maxillary sinus hypoplasia (n=2, 10%), unilateral concha bullosa (n=2, 10%) and pneumatized Agger Nasi cell (n=1, 4.7%). Conclusions: 52% of patients with common variable immunodeficiency (CVID) presented chronic rhinosinusitis, 58% mild according to Lund- Mackay score; the main affected sinus was bilateral maxillary sinus (33%). Due to the prevalence of chronic rhinosinusitis in patients with common variable immunodeficiency, paranasal sinus CT scan should be performed in all patients to establish diagnosis and treatment.