Recurrent Otitis Media in Association With Immunodeficiency

Abstract

Background & Purpose: Recurrent and chronic infections of the ear, throat and nose are one of the most important health problems worldwide, and they clearly affect the quality of life in adults and children. In spite of proper diagnosis and proper treatment, groups of these patients do not respond to routine treatment and are still being symptomatic and have chronic complications in these patients. Various studies have shown that the immune system is defective in some patients with frequent and chronic infections of the ear, throat and nose. Therefore, the present study was conducted to evaluate the relative frequency of primary immunodeficiency diseases in children with sinusitis and recurrent middle ear infections. Methods & Materials: This study evaluated underlying immune defects in patients with otitis media or recurrent sinusitis. Serum levels of IgA, IgG and IgM were evaluated by nephlometric test. In addition, a complete count of blood cells was also evaluated. The rate of humoral response to diphtheria and tetanus was also assessed. NBT was used to evaluate the immune system. Results: Out of 62 patients, 12 patients (19%) had defects in at least one antibody class. Five patients with IgA deficiency (which 2 of them have also showed IgG concurrent deficiency) were seen. Also, 4 patients had IgG deficiency and 3 patients showed IgM deficiency. None of the patients had abnormal cell count. NBT response was also normal in all patients. Conclusion:In general, the findings of the present study in line with previous studies showed that a large proportion of children with recurrent otitis media and sinusitis have abnormal immunologic function. Therefore, it is recommended that the evaluation of immune deficiency be considered in these patients.

A model of chronic, transmissible Otitis Media in mice

“…The observation that B cell and T cell deficient mice had significantly larger numbers of bacteria in the middle ear indicates that both B and T cell responses, are important in the control of bacterial numbers, but are not sufficient to clear the infection. These observations are in agreement with earlier descriptions of patients with humoral antibody defects that are particularly prone to middle ear infections [36, 37]. Mouse molecular tools can now define how each of many host immune functions might be involved in discreet stages of OM, from the pattern recognition receptors that might sense initial infection (Fig 6A), through the regulatory cells and molecules involved in the inflammatory response and the ultimate maturation of an adaptive response (Fig 6B).…”