Home Medizin Sinusitis ist mit einem erhöhten rheumatischen Erkrankungsrisiko verbunden

Sinusitis ist mit einem erhöhten rheumatischen Erkrankungsrisiko verbunden

von NFI Redaktion

According to a study published in an open-access journal, the common inflammatory condition sinusitis is associated with a 40% increased risk of a later diagnosis of a rheumatic disease, particularly in the 5 to 10 years before the onset of symptoms RMD open.

The risks appear to be highest in cases of a clotting disorder (antiphospholipid syndrome) and a condition that affects the body’s fluid production such as saliva and tears, known as Sjögren’s syndrome.

Sinusitis refers to inflammation of the sinus membrane, the small, air-filled cavities behind the cheekbones and forehead. Previous research has indicated a link between various types of lung irritants, including air pollution and respiratory infections, and conditions like rheumatoid arthritis.

However, it is not clear if sinusitis could also be a potential predisposing factor for other types of rheumatic diseases. To address this gap in knowledge, researchers conducted a case-control study.

They used data from the Rochester Epidemiology Project (REP), a system linking medical records of over 500,000 individuals who lived in Olmsted County, Minnesota, between 1966 and 2014.

The study sample included 1729 adults newly diagnosed with a systemic rheumatic autoimmune disease such as rheumatoid arthritis, antiphospholipid syndrome, Sjögren’s syndrome, or vasculitis. Each of these patients (average age 63; two-thirds female) was matched with three individuals (total of 5187) without a rheumatic disease based on age at diagnosis and gender.

Cases of sinusitis before the diagnosis of a rheumatic disease were divided into time periods of 1 to 5 years; 5 to 10 years; and 10 or more years.

Potential influencing factors were considered: age, weight (BMI), and smoking status at the time of rheumatic disease diagnosis, gender, race, and ethnicity.

The average time between a sinusitis episode and the diagnosis of a rheumatic disease was just over 7.5 years, with the most common diagnoses being rheumatoid arthritis (688) and polymyalgia rheumatica (610).

A history of sinusitis was associated with a 40% increased risk of a new diagnosis of a rheumatic disease, with the strongest association observed in systemic rheumatic autoimmune diseases like antiphospholipid syndrome (7-fold increased risk) and Sjögren’s syndrome (more than doubled). The presence of acute sinusitis was linked to an 18% increased risk of seronegative rheumatoid arthritis (symptoms but no detectable antibodies).

The association between sinusitis and newly diagnosed rheumatic disease was strongest in the 5–10 years before the onset of symptoms, with an overall 70% higher risk, tripling for Sjögren’s syndrome, and doubling for polymyalgia rheumatica.

The more frequent the bouts of sinusitis, the greater the chances of a new diagnosis of a rheumatic disease. For example, the likelihood of diagnosing a systemic autoimmune disease was almost five times higher in patients with 7 or more episodes, nearly nine times higher for Sjögren’s syndrome, and twice as high for vasculitis.

Recurrent sinusitis episodes without a history also showed a significant dose-response relationship with seronegative rheumatoid arthritis, with a risk factor of four or more episodes.

Overall, the association between sinusitis and rheumatic diseases was strongest in non-smokers.

Since this is an observational study, no definitive conclusions can be drawn about causal factors. The researchers also acknowledge several limitations in their findings, including a predominantly white study population and few cases of certain types of rheumatic diseases.

They also note that a reverse causation, where rheumatic diseases themselves increase the risk of sinusitis, cannot be ruled out.

However, bacterial pathogens, as seen in sinusitis, may play a role in rheumatic diseases. Additionally, sinusitis is linked to accelerated arterial hardening, giving additional weight to its potential inflammatory effects, explain the researchers.

In conclusion, „These findings point towards a role of sinus inflammation in the development and possibly pathogenesis of rheumatic diseases.“

Source:

Journal Reference:

Kronzer, VL, et al. (2024) Association between Sinusitis and Rheumatic Diseases: A Population-Based Study. RMD open. doi.org/10.1136/rmdopen-2023-003622.

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