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Sinusitis and Pnemococcal Antibody Deficiency

Dr. Kagen:

We have recently done a blood study on a family member - JD - who was found to have low Neumococcal Antibody IGG with Immunoglobulin E being 6.3. Soon he will be given allergy skin tests.

Chronic sinusitis brought him to be tested. He suffers from mild headache and dizziness. A recent CT of the sinuses proved no sinus congestion remaining after long antibiotic treatment, however the mild headache and dizziness still remain.

If the sinusitis has cleared up, why does he still have the mild headache and dizziness?

Could they be symptomatic of a secondary disease to the Antibody Deficiency Syndrome? If so, then what diseases should I ask the allergist to help me explore for JD which may carry this symptomology? Also, what type of specialist is best equipped to help people with Antibody Deficiency Syndrome?

Thank you for any information you may suggest or lines of exploration to help JD live more healthfully with his problem. Please also tell me who is answering me if you can.)


Thanks for asking about chronic sinusitis, continued sinus headaches and a possible pneumococcal antibody deficiency.

It is very unlikely that an isolated deficiency of antibody production against the bacteria we call pneumococci has caused your family member's illness of chronic sinusitis. When patients have antibody deficiencies, they have repeated and often times serious life threatening infections not only in the sinus region but throughout the entire body. Skin, sinus, gastrointestinal and lung infections are the most commonly affected areas affected in antibody deficient patients.

Patients with chronic sinusitis most often have underlying illnesses such as allergy, anatomical defects [e.g. plugged drain to a sinus, deviated nasal septum] and rarely antibody deficiencies.

The most common antibody deficiency associated with recurrent sinus, ear and lung infections is an IgA deficiency which is present in about 1 in 400 individuals. IgA is the abbreviation for Immunoglobulin A, which is a special type of antibody responsible for protecting mucosal surfaces of the body in the upper airways, the lungs, the intestinal tract and the reproductive mucosal linings.

Antibodies against pneumococcal bacteria are important in defending humans from infections. A bacterial vaccine, Pneumovax, which contains many of the pneumococcal antigens has been credited with decreasing the number of lung infections [pneumonia] especially in the elderly.

Rarely does pneumococcal immune deficiency alone cause chronic sinusitis, especially in the young.

Symptoms of headache and dizziness are often seen in patients with uncontrolled allergies. Your local Allergy Specialist should be able to make an accurate diagnosis of your family member's illness.

I hope this information is useful to you and your family.

Good luck.

Steve Kagen, M.D.