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Rhinosinusitis: Is My Rhinosinusitis a
Sign of Weakness in My Immune System?
Weakness in the immune system is unusual, occurring
only in about 5% of chronic rhinosinusitis patients. Two common types of
immune deficiency are associated with an increased prevalence of
rhinosinusitis: IgA deficiency and hypogammaglobulinemia.
IgA deficiency occurs in about 1 in 700 people in
the United States. The diagnosis is made by a blood test. It tends to
run in families, but the pattern of inheritance is unknown. IgA
antibodies are secreted into the mucus layer produced in the sinuses.
The antibodies help to fight infection by bacteria and viruses.
Patients with IgA deficiency have an increased incidence of sinus and
ear infections but are usually healthy otherwise. There is no cure for
IgA deficiency. Gamma globulin treatments are not recommended, since
they contain very little IgA.
Hypogammaglobulinemia is much less common than IgA
deficiency. It involves a deficiency in IgG antibodies. The diagnosis
is made by blood tests and by testing a patient’s immune response to
vaccines. IgG is the most important type of antibody for fighting
infections. Patients with IgG deficiency may experience sinus
infections, ear infections, bronchitis and pneumonia. In severe cases,
hypogammaglobulinemia may be treated with "gammaglobulin,"
which is given intravenously. This type of treatment is known as
"IVIG", and it is very effective at correcting
hypogammaglobulinemia. IVIG treatments are very expensive and must be
given every month for life.
For more information about immune deficiencies,
please see the Immune Deficiency Foundation’s Web site at www.primaryimmune.org.
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