The Risk of Rheumatic Disorders Among Patients With Rhinosinusitis: A Systematic Review and Meta-Analysis.

IF 6.8 2区医学 Q1 OTORHINOLARYNGOLOGY

International Forum of Allergy & Rhinology Pub Date : 2025-09-05 DOI:10.1002/alr.70032

Arshbir Aulakh, Pradumn Choudhary, Gurwinder Sidhu, Deanna Gigliotti, Jane Jun, Andrew Thamboo

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引用次数: 0

Abstract

Background: Emerging evidence suggests a possible link between rhinosinusitis and systemic rheumatic diseases; however, no meta-analysis has comprehensively examined this association to date. We aimed to investigate if patients with rhinosinusitis have a predisposition to unmasking rheumatic diseases compared to individuals without rhinosinusitis.

Methods: A comprehensive search in MEDLINE, Embase, Cochrane Library, and Web of Science was conducted until February 2025 for studies characterizing rheumatic disease incidence, prevalence, and risk in cohorts of rhinosinusitis patients. The search was limited to records authored in English and involved combining both rhinitis and sinusitis Medical Subject Headings (MeSH) terms. Relative risk and prevalence data were pooled using random-effects models.

Results: Nine studies with 86,081 rhinosinusitis patients were included. Chronic rhinosinusitis (CRS) was significantly associated with increased risk of rheumatoid arthritis (RA) (odds ratio [OR]: 1.70; 95% CI: 1.44-2.00; p < 0.00001), systemic lupus erythematosus (OR: 1.61; 95% CI: 1.25-2.08; p = 0.0002), and ankylosing spondylitis (OR: 1.48; 95% CI: 1.26-1.72; p < 0.00001). Acute rhinosinusitis (ARS) showed weaker associations, notably with seronegative RA. Rheumatic disease prevalence in rhinosinusitis patients was highest for RA (10%, 95% CI: 8.2-13).

Conclusion: Rhinosinusitis, particularly CRS, is associated with several rheumatic diseases. Mechanisms of mucosal immune dysregulation associated with rhinosinusitis may contribute to, or act in parallel with, the pathogenesis of systemic autoimmunity. Management of CRS (surgical or immunomodulatory) may lead to the sentinel presentation and subsequent identification of previously undiagnosed systemic autoimmune conditions. Clinicians should maintain a high index of suspicion for early autoimmune symptoms in rhinosinusitis patients.

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鼻窦炎患者风湿性疾病的风险：一项系统综述和荟萃分析

背景：新出现的证据表明鼻窦炎与系统性风湿病之间可能存在联系；然而，到目前为止，还没有荟萃分析全面地研究了这种关联。我们的目的是调查与没有鼻窦炎的个体相比，患有鼻窦炎的患者是否有暴露风湿性疾病的倾向。方法：在MEDLINE、Embase、Cochrane图书馆和Web of Science中进行综合检索，直到2025年2月，以确定鼻窦炎患者队列中风湿性疾病的发病率、患病率和风险。搜索仅限于用英文撰写的记录，并涉及鼻炎和鼻窦炎医学主题标题（MeSH）术语。使用随机效应模型汇总相对风险和患病率数据。结果：纳入9项研究，共纳入86081例鼻窦炎患者。慢性鼻窦炎（CRS）与类风湿关节炎（RA）风险增加显著相关（优势比[OR]: 1.70; 95% CI: 1.44-2.00; p）结论：鼻窦炎，特别是CRS，与几种风湿性疾病相关。与鼻窦炎相关的粘膜免疫失调的机制可能有助于或与全身性自身免疫的发病机制并行。CRS的管理（手术或免疫调节）可能导致前哨表现和随后未确诊的全身自身免疫性疾病的识别。临床医生应该对鼻窦炎患者的早期自身免疫症状保持高度的怀疑。

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.