Researchers did this study to inform the approach to the evaluation of pediatric patients with rhinosinusitis, and this retrospective pilot study examined the prevalence of abnormal results detected on immunologic testing in pediatric patients with CRS and RARS.
Researchers identified patients using the International Classification of Diseases 9/10 codes. Imaging, endoscopy findings, and clinical criteria were used to diagnose CRS and RARS. We reviewed available results, including quantitative Igs, thyroid evaluation, complete blood count, and titers to Streptococcus, HiB, Diphtheria, and Tetanus. Statistical analyses were performed with the Mann–Whitney U test and Fisher’s exact test.
Researchers identified 27 patients that met diagnostic criteria for CRS or RARS. Eight patients underwent adenoidectomy, and 5 underwent endoscopic sinus surgery. Within this cohort, there was an increased incidence of low protective titers to polysaccharide vaccines. HiB titers were not protective in 35% of our cohort. Inadequate pneumococcal protection was more common in patients >10 years, while deficient IgM was more common in those <10 years.
The study concluded that high-yield testing in pediatric rhinosinusitis should include titers to polysaccharide antigens, specifically Streptococcus pneumoniae and H. influenzae.