Evaluation and treatment of rhinosinusitis with primary antibody deficiency in children: Evidence-based review with recommendations

IF 7.2 2区医学 Q1 OTORHINOLARYNGOLOGY International Forum of Allergy & Rhinology Pub Date : 2024-10-15 DOI:10.1002/alr.23468

Chadi A. Makary MD, Antoine Azar MD, David Gudis MD, Anna Crawford MLIS, Paavali Hannikainen MD, Jean Kim MD, PhD, Stephanie Joe MD, Adam J. Kimple MD, Kent Lam MD, Jivianne T. Lee MD, Amber U. Luong MD, PhD, Sonya Marcus MD, Erica McArdle MD, Warren Mullings MD, Brian P. Peppers DO, PhD, Callum Lewandrowski DO, Sandra Y. Lin MD, Hassan H. Ramadan MD, MSc, Austin S. Rose MD, MBA, Lindsey Ryan MD, Elina Toskala MD, PhD, MBA, Fuad M. Baroody MD

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Abstract

Background

There is clear evidence that prevalence of primary antibody deficiency (PAD) is higher in children with chronic rhinosinusitis (CRS) than in the general population. The purpose of this multi-institutional and multidisciplinary evidence-based review with recommendations (EBRR) is to thoroughly review the literature on rhinosinusitis with PAD, summarize the existing evidence, and provide recommendations on the evaluation and management of rhinosinusitis in children with PAD.

Methods

The PubMed, Embase, and Cochrane databases were systematically reviewed from inception through December 2023. Studies on the evaluation and management of rhinosinusitis in PAD patients were included. An iterative review process was utilized in accordance with EBRR guidelines. Levels of evidence and recommendations on the evaluation and management principles for PAD were generated.

Results

A total of 50 studies were included in this evidence-based review. These studies were evaluated on the incidence of PAD in rhinosinusitis patients, the incidence of rhinosinusitis in PAD patients, and on the different treatment modalities used and their outcome. The aggregate quality of evidence varied across the reviewed domains.

Conclusion

Based on the currently available evidence, the incidence of PAD in children with recalcitrant CRS can be significantly elevated. Despite the presence of multiple studies addressing rhinosinusitis and PAD, the level of evidence supporting different treatment options continues to be lacking. Optimal management requires a multidisciplinary approach through collaboration with clinical immunology. There is need for higher level studies that compare different treatments in children with PAD and rhinosinusitis.

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评估和治疗儿童原发性抗体缺乏性鼻炎：基于证据的综述与建议。

背景：有明确证据表明，慢性鼻炎（CRS）患儿的原发性抗体缺乏症（PAD）发病率高于普通人群。本篇多机构、多学科循证建议综述（EBRR）旨在全面回顾有关 PAD 鼻炎的文献，总结现有证据，并就 PAD 儿童鼻炎的评估和管理提出建议：方法：对 PubMed、Embase 和 Cochrane 数据库从开始到 2023 年 12 月的内容进行了系统性回顾。纳入了有关 PAD 患者鼻炎评估和管理的研究。根据 EBRR 指南采用了迭代审查流程。结果：本次循证审查共纳入了 50 项研究。这些研究对鼻炎患者中 PAD 的发病率、PAD 患者中鼻炎的发病率以及所采用的不同治疗方法及其结果进行了评估。在所审查的各个领域中，证据的总体质量各不相同：根据现有证据，顽固性CRS患儿的PAD发病率可能会显著升高。尽管有多项研究涉及鼻炎和 PAD，但支持不同治疗方案的证据仍然缺乏。最佳治疗需要与临床免疫学合作，采用多学科方法。有必要开展更高级别的研究，对 PAD 和鼻炎患儿的不同治疗方法进行比较。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International Forum of Allergy & Rhinology OTORHINOLARYNGOLOGY-

CiteScore

11.70

自引率

10.90%

发文量

185

审稿时长

6-12 weeks

期刊介绍： International Forum of Allergy & Rhinologyis a peer-reviewed scientific journal, and the Official Journal of the American Rhinologic Society and the American Academy of Otolaryngic Allergy. International Forum of Allergy Rhinology provides a forum for clinical researchers, basic scientists, clinicians, and others to publish original research and explore controversies in the medical and surgical treatment of patients with otolaryngic allergy, rhinologic, and skull base conditions. The application of current research to the management of otolaryngic allergy, rhinologic, and skull base diseases and the need for further investigation will be highlighted.