Understanding the Propensity for Chronic Sinusitis in Patients on Immunosuppressive Therapy

American Journal of Rhinology & Allergy
Peter PapagiannopoulosBobby A Tajudeen

Abstract

Chronic rhinosinusitis (CRS) is a frequently observed condition in patients with immunodeficiency secondary to immunosuppressive medications. The histologic features of CRS among patients undergoing immunosuppressive treatment have yet to be determined and may have important implications on understanding the pathophysiology of the disease process. A structured histopathology report was utilized to analyze sinus tissue removed during functional endoscopic sinus surgery (FESS). Histopathology variables, Lund-Mackay score (LMS), and sinonasal outcome test 22 scores were compared among patients with CRS on immunosuppressive therapy (CRSi), CRS without nasal polyps (CRSsNP) patients, and CRS with nasal polyps (CRSwNP) patients. Fifteen CRSi, 36 CRSwNP, and 56 CRSsNP patients undergoing FESS were analyzed. Compared to CRSsNP, CRSi patients exhibited a trend toward increased moderate-severe inflammation (66.7% vs 42.1%, P < .080), increased neutrophil infiltrate (40.0% vs 24.6%, P < .192), and decreased fibrosis (26.7% vs 43.9%, P < .182). Compared to CRSwNP, CRSi patients demonstrated decreased fibrosis (26.7% vs 66.7%, P < .010), decreased eosinophil aggregates (13.3% vs 44.4%, P < .032), and a trend toward fewer eosinophils per hig...Continue Reading

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Citations

Dec 4, 2019·International Forum of Allergy & Rhinology·Peter PapagiannopoulosNithin D Adappa
Jan 1, 2020·The Annals of Otology, Rhinology, and Laryngology·Ashwin GantiBobby A Tajudeen
Nov 30, 2018·American Journal of Rhinology & Allergy·Mohamad R Chaaban
Jul 16, 2020·International Forum of Allergy & Rhinology·Shireen SamargandyJonathan Yip
Jan 1, 2020·Laryngoscope Investigative Otolaryngology·Michael J MarinoDevyani Lal
Oct 23, 2019·Laryngoscope Investigative Otolaryngology·Michael J MarinoDevyani Lal
Dec 7, 2018·Current Opinion in Otolaryngology & Head and Neck Surgery·Aryan D Shay, Bobby A Tajudeen
Nov 26, 2020·International Forum of Allergy & Rhinology·Richard R OrlandiBing Zhou
May 18, 2021·World Journal of Otorhinolaryngology - Head and Neck Surgery·Aviv SpillingerGarret Choby

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