Sinusitis Tied To Elevated Rheumatic Disease Risk

Zaid Siddiqui

, News

Research published in the open-access journal RMD Open reveals a significant connection between sinusitis, a common inflammatory condition, and a 40% increased risk of subsequent rheumatic disease diagnosis. This association is particularly pronounced in the 5 to 10 years leading up to the onset of symptoms. The study suggests that individuals with sinusitis face higher risks, especially concerning a blood clotting disorder (antiphospholipid syndrome) and Sjögren’s syndrome, which affect fluid production in the body.


Sinusitis involves inflammation of the sinuses and the air-filled cavities behind the cheekbones and forehead. Previous research has linked various lung irritants, such as air pollution and respiratory infections, to the development of rheumatoid arthritis. However, it remains unclear if sinusitis could be a predisposing factor for other types of rheumatic diseases.


To address this knowledge gap, researchers conducted a case-control study using data from the Rochester Epidemiology Project, involving over 500,000 people in Olmsted County, Minnesota, between 1966 and 2014. The study included 1729 adults diagnosed with systemic autoimmune rheumatic diseases or vasculitis, matched with 5187 individuals without rheumatic disease.


The analysis, accounting for factors like age, weight, smoking status, sex, race, and ethnicity, revealed that a history of sinusitis was linked to a 40% increased risk of any new rheumatic disease diagnosis. The association was strongest for systemic autoimmune rheumatic diseases, such as antiphospholipid syndrome (7-fold increased risk) and Sjögren’s syndrome (more than double the risk).


The timing of sinusitis was crucial, with the highest risk observed 5–10 years before symptom onset, showing a 70% overall increase. The frequency of sinusitis episodes correlated with a greater chance of a new rheumatic disease diagnosis. Additionally, the study indicated a dose-response association between serial episodes of sinusitis and seronegative rheumatoid arthritis.


It’s important to note that this is an observational study, limiting the establishment of definitive causal factors. The researchers acknowledge study limitations, such as a predominantly white population and few cases of certain rheumatic diseases. Reverse causation, where rheumatic diseases increase sinusitis risk, cannot be ruled out. However, the researchers suggest a potential role of bacterial pathogens involved in sinusitis in rheumatic disease, along with sinusitis accelerating artery hardening and reinforcing its potential inflammatory effects. The study concludes that sinus inflammation may play a role in the presentation and, possibly, the pathogenesis of rheumatic disease.


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