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Clinical Characteristics of Patients with Chronic Rhinosinusitis without Nasal Polyps in a Tertiary Care Setting
Saturday, March 5, 2016
South Exhibit Hall H (Convention Center)
Mariel G Rosati, MD, Whitney W. Stevens, MD PhD, Newton Li, MD, Sumit Bose, MD, Leslie C. Grammer, MD FAAAAI, Kathryn E. Hulse, PhD, Atsushi Kato, PhD, Robert C. Kern, MD, Bruce K. Tan, MD, Stephanie S. Smith, MD, David B. Conley, MD, Pedro C. Avila, MD, Robert P. Schleimer, PhD FAAAAI, Anju T. Peters, MD FAAAAI
Rationale:

Patients with chronic rhinosinusitis without nasal polyps (CRSsNP) have not been well characterized phenotypically.  We performed a retrospective chart review at Northwestern University of subjects with CRSsNP using patients with CRS with nasal polyps (wNP) as a comparator.

Methods:

Patients with a history of CRS with positive sinus CT (>18 y.o.) evaluated in the Allergy/Immunology or Otolaryngology clinics between 2002-2012 were randomly identified via ICD-9 codes.  Characteristics analyzed included demographics, atopy, radiologic sinus severity, and comorbid diseases.

Results:

319/507(63%) were female in the CRSsNP group compared to 393/847(45%) in the CRSwNP group.  Severity of sinus disease was similar between men and women with CRSsNP.  Prevalence of atopy was 52% in CRSsNP versus 76% in CRSwNP (p<0.0001). In CRSsNP, atopic patients had more severe disease radiographically compared to non-atopic patients (p<0.005).  Prevalence of asthma was 36% in CRSsNP versus 56% in CRSwNP (p<0.0001).  Comorbid asthma was not associated with sinus disease severity in CRSsNP but was significantly associated with disease severity in CRSwNP (p<0.0001). Comorbid conditions observed in CRSsNP included humoral immunodeficiency (5.7%) and autoimmune diseases (13.3%).

Conclusions:

This is the largest clinical characterization of patients with CRSsNP to date.  CRSsNP patients were predominantly female whereas CRSwNP patients were predominantly male. The prevalence of asthma was higher in our cohort of CRSsNP patients than previously described. Atopy was associated with more severe disease in CRSsNP while asthma and gender were not associated with severity. The prevalence of comorbid autoimmune diseases in CRSsNP was higher than expected in the general population (~7.6-9.4%).