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Managing Frontal Sinusitis from Systemic Inflammatory Disease

  • Lester E. Mertz
  • Rohit Divekar
  • Matthew A. Rank
Chapter

Abstract

In this chapter, we outline the systemic diseases that can be encountered in patients with chronic frontal sinusitis, starting with identification of clinical patterns. Next, we compare and contrast the various conditions that may be associated with chronic frontal sinusitis, including allergic fungal sinusitis, aspirin-exacerbated respiratory disease, common variable immune deficiency, eosinophilic granulomatosis with polyangiitis, granulomatosis with polyangiitis, HIV, IgG4-related disease, odontogenic sinusitis, cystic fibrosis, primary ciliary dyskinesia, sarcoidosis, and cocaine-induced midline destructive lesions. We discuss examination features as well as laboratory and radiographic findings. Finally, we review in detail the management options specific to the identified systemic diseases.

Keywords

Allergic fungal sinusitis Aspirin-exacerbated respiratory disease Common variable immune deficiency Eosinophilic granulomatosis with polyangiitis Granulomatosis with polyangiitis HIV IgG4-related disease Odontogenic sinusitis Cystic fibrosis Primary ciliary dyskinesia Sarcoidosis Cocaine-induced midline destructive lesions 

Abbreviations

ACE

Angiotensin-converting enzyme

ACR

American College of Rheumatology

AERD

Aspirin-exacerbated respiratory disease

AFS

Allergic fungal sinusitis

ANCA

Anti-neutrophil cytoplasmic antibody

Anti-MPO ab

Anti-myeloperoxidase antibody

Anti-PR3 ab

Anti-proteinase 3 antibody

BVAS

Birmingham Vasculitis Activity Score

BVAS/WG

BVAS for Wegener’s granulomatosis (GPA)

C-ANCA

Cytoplasmic anti-neutrophil cytoplasmic antibody

CF

Cystic fibrosis

CHCC

Chapel Hill Consensus Conference

CIMDL

Cocaine-induced midline destructive lesions syndrome

CRP

C-reactive protein

CRS

Chronic rhinosinusitis

CRSsNP

Chronic rhinosinusitis without (sans) nasal polyps

CRSwNP

Chronic rhinosinusitis with nasal polyps

CVID

Common variable immune deficiency

EGPA

Eosinophilic granulomatosis with polyangiitis (Churg-Strauss syndrome)

EMA

European Medical Agency

ENT

Ear, nose, and throat

ESR

Erythrocyte sedimentation rate

EULAR

European League Against Rheumatism

GPA

Granulomatosis with polyangiitis (Wegener’s granulomatosis)

HEENT

Head, eye, ear, nose, and throat

HIV

Human immunodeficiency virus

Ig

Immunoglobulin

IgG4-RD

IgG4-related disease

MPA

Microscopic polyangiitis

P-ANCA

Perinuclear anti-neutrophil cytoplasmic antibody

PCD

Primary ciliary dyskinesia

TMP/SMX

Trimethoprim/sulfamethoxazole

VDI

Vasculitis damage index

Notes

Acknowledgments

We thank Drs. Rodrigo Cartin-Ceba and Devyani Lal, both from Mayo Clinic Arizona, for their input on this chapter.

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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Lester E. Mertz
    • 1
  • Rohit Divekar
    • 2
  • Matthew A. Rank
    • 3
  1. 1.Division of Rheumatology, Department of MedicineMayo ClinicScottsdaleUSA
  2. 2.Division of Allergic DiseasesMayo ClinicRochesterUSA
  3. 3.Division of Allergy, Asthma, and Clinical ImmunologyMayo ClinicScottsdaleUSA

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