Allergic vs nonallergic rhinitis: which is more predisposing to chronic rhinosinusitis?

Gelincik, Aslı; Büyüköztürk, Suna; Aslan, İsmet; Aydın, Salih; Özşeker, Ferhan; Çolakoğlu, Bahattin; Dal, Murat

doi:10.1016/s1081-1206(10)60829-0

Cited by 34 publications

(30 citation statements)

References 22 publications

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“…These results agree with those of another recent cohort study that did not show a more severe disease or worsened treatment outcome in sensitized versus nonsensitized patients who were surgically treated and observed for more than 1 year [7]. Gelincik et al [8] reported on the evaluation of CRS and asthma in a consecutive series of patients evaluated in an allergy clinic. They did not find an increase in CRS or asthma in allergic compared with nonallergic patients as assessed by SPT.…”

Section: Allergysupporting

confidence: 90%

“…They did not find an increase in CRS or asthma in allergic compared with nonallergic patients as assessed by SPT. Additionally CT scores did not differ by allergic status [8]. Similarly, Pearlman et al [9] carried out a cohort study of CRS patients subjected to allergy and asthma evaluation; about half of the CRS patients had positive SPTs, and there was no association between positive SPT status and severity of CRS.…”

Section: Allergymentioning

confidence: 94%

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Rhinosinusitis and Comorbidities

Ryan

Brooks

2010

Curr Allergy Asthma Rep

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A variety of systemic conditions impact the incidence, severity, prognosis, and treatment approach in patients with chronic rhinosinusitis (CRS). The controversy surrounding the impact of allergic rhinitis on CRS continues, but it is reasonable to consider and treat allergic sources of inflammation in any patient with CRS. CRS is more severe in patients with aspirin sensitivity but improves--at least temporarily--to the same degree as in non-aspirin-sensitive patients, given appropriate therapy. Polypoid rhinosinusitis in cystic fibrosis patients is characterized by compromised mucociliary clearance and infection with staphylococcal and pseudomonal organisms. Affected individuals require frequent antibiotic treatment, saline lavage, and repeated surgeries. Rhinosinusitis is among the most common infectious complications of humoral immunodeficiency, which is not uncommon in patients with refractory CRS. The treatment approach in immunodeficiency includes aggressive antibiotic treatment and intravenous immunoglobulin. Specific diagnosis of comorbid systemic conditions with CRS will facilitate appropriate management.

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Section: Allergysupporting

confidence: 90%

Section: Allergymentioning

confidence: 94%

Rhinosinusitis and Comorbidities

Ryan

Brooks

2010

Curr Allergy Asthma Rep

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“…This is likely a more accurate record of pre-morbid illness than patient recall typically used in most previous studies of pre-morbid risk factors in CRS(7, 14, 15). This study was performed in an area of remarkable population stability and encompassed patients receiving care in a variety of settings and is less susceptible to referral bias than most specialty-based studies of CRS.…”

Section: Resultsmentioning

confidence: 99%

Incidence and associated premorbid diagnoses of patients with chronic rhinosinusitis

Tan

Chandra

Pollak

et al. 2013

Journal of Allergy and Clinical Immunology

202

236

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Background Chronic rhinosinusitis (CRS) is a prevalent condition with underexplored risk factors. Objectives To determine CRS incidence and evaluate associations with a range of pre-morbid medical conditions for CRS without nasal polyps (CRSsNP) and CRS with nasal polyps (CRSwNP) using real-world clinical practice data. Methods Electronic health record (EHR) data from 446,480 Geisinger Clinic primary care patients was used for a retrospective longitudinal cohort study for data from 2001–2010. Using logistic regression, newly diagnosed CRS cases between 2007-2009 were compared to frequency-matched controls on pre-morbid factors in the immediate (0-6 months), intermediate (7-24 months) and entire observed timeframes prior to diagnosis. Results : The average incidence of CRS was 83 (±13) CRSwNP cases per 100,000 person-years and 1048 (±78) CRSsNP cases per 100,000 person-years. Between 2007-2009, 595 patients with incident CRSwNP and 7523 patients with incident CRSsNP were identified and compared to 8118 controls. Compared to controls and CRSsNP, CRSwNP patients were older and more likely to be male. Prior to diagnosis, CRS patients had a higher prevalence of acute rhinosinusitis, allergic rhinitis, chronic rhinitis, asthma, gastroesophageal reflux disease (GERD), adenotonsillitis, sleep apnea, anxiety and headaches (all p < 0.001). CRSsNP had a higher pre-morbid prevalence of infections of the upper and lower airway, skin/soft tissue and urinary tract (all p < 0.001). In the immediate and intermediate timeframes analyzed, patients who developed CRS had more outpatient encounters and antibiotic prescriptions (p < 0.001) but guideline-recommended diagnostic testing was performed in a minority of cases. Conclusions Patients who are diagnosed with CRS have a higher pre-morbid prevalence of anxiety, headaches, GERD, sleep apnea and infections of the respiratory system and some non-respiratory sites that results in higher antibiotic, corticosteroid and health care utilization. The use of guideline-recommended diagnostic testing for confirmation of CRS remains poor.

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“…Inhalant allergy has also been highly associated with CRS, with some studies demonstrating prevalence of 57.4% to 84% in CRS patients undergoing ESS . The exact impact of inhalant allergy on CRS disease severity is unclear, with data demonstrating both higher and lower disease burden as measured by Lund‐Mackay CT scores in atopics compared to nonatopics …”

Section: Introductionmentioning

confidence: 99%

“…16,17 The exact impact of inhalant allergy on CRS disease severity is unclear, with data demonstrating both higher and lower disease burden as measured by Lund-Mackay CT scores in atopics compared to nonatopics. 18,19 The prevalence of sinonasal polyposis ranges between 0.5% and 4.3% in national population-based surveys 5 ; however, the reported prevalence in studies assessing outcomes of sinus surgery for CRS ranges from 44.9% to 69.4% of patients. 6,7 The presence of polyps also portends worsened objective disease severity by endoscopy and sinus CT scores, and higher postoperative symptom scores after surgery.…”

Section: Introductionmentioning

confidence: 99%