[PAGID] Chronic rhinosinusitis in antibody deficiency diseases

[Dewton Vasconcelos]

Dear Dr. Kumar

I usually prescribe intensive nasal hygiene with isotonic saline 
(hypertonic when there is an "anatomical" problem such as hypertrophy of 
turbinates, sometimes associated to nasal steroids), and antibiotics in 
the exacerbations. Exercises such as running or biking sometimes help 
due to the fluidification of the secretion (pulmonary and nasosinusal). 
Some patients respond to increases in the doses of IVIg, with a nadir of 
800 mg/dl of IgG. Moreover, some patients that do not respond to any of 
these measures can benefit of topical application of IgG (IVIg 5%) for a 
while.

Best regards,

Dewton Vasconcelos
University of São Paulo Medical School


Ashish Kumar escreveu:

> The mother of one one of my patients with XLA does not want to use 

> prolonged antibiotics for the management of his chronic 

> rhinosinusitis. His symptoms disappear while on he is on Augmentin but 

> reappear when stopped. Has anyone tried nasal steroids alone or in 

> combination with antibiotics/higher dose of IVIG successfully?

> Is there published consensus on the appropriate management of chronic 

> rhinosinusitis in patients with antibody deficiency diseases - most of 

> what I found suggest that there is none. Maybe an opportunity for a 

> collaborative group trial?

>


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