Sinusitis Linked to 40% Heightened Risk of Rheumatic Diseases

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Experts say chronic sinus infections can lead to rheumatic diseases. Stefania Pelfini, La Waziya Photography/Getty Images
  • Between 10% and 33% of the global population lives with rheumatic disease.
  • Previous studies have identified potential risk factors for rheumatic disease, including age, smoking, and environmental triggers.
  • Researchers from the Mayo Clinic are reporting that sinusitis is associated with a 40% increased risk of a subsequent diagnosis of rheumatic disease, especially in the five to 10 years before rheumatic disease symptoms begin.

Between 10% and 33% of the world’s population lives with rheumatic disease — an umbrella term referring to diseases affecting the body’s joints, bones, ligaments, and muscles.

Types of rheumatic diseases include gout, rheumatoid arthritis, Sjögren’s syndrome, osteoarthritis, fibromyalgia, and lupus.

Some potential risk factors for developing a rheumatic disease may include age, gender, family history, smoking, environmental triggers, and obesity.

Now researchers from the Mayo Clinic in Minnesota have found that sinusitis — inflammation of the body’s sinuses — is associated with a 40% increased risk of a subsequent diagnosis of a rheumatic disease, especially in the five to 10 years before rheumatic disease symptoms begin.

Their study was published in the journal RMD Open.

Dr. Cynthia Crowson, the lead statistician in the Division of Clinical Trials and Biostatistics with a joint appointment in the Division of Rheumatology at the Mayo Clinic and lead author of this study, told Medical News Today her team decided to look for a link between sinusitis and rheumatic disease because smoking has been linked to the development of rheumatic diseases as well as air pollutants and other conditions involving the respiratory system — nose, throat, and lungs.

“Sinusitis is related to these factors and the association between sinusitis and rheumatic diseases has not been well studied,” Crowson explained. “Factors that are associated with developing a disease may hold the key to preventing (the) development of the disease in the future.”

Previous research shows smoking can negatively impact rheumatic and musculoskeletal diseases and smoking cessation in people with rheumatoid arthritis was linked to lower disease activity and a reduced risk for cardiovascular disease.

Past studies have found a link between air pollutants and a potential increased risk for Sjögren’s syndrome, rheumatoid arthritis, lupus, and gout.

Other research says that lung issues and respiratory conditions in people with rheumatic disease are known issues.

For this study, Crowson and her team analyzed medical record data from the Rochester Epidemiology Project, which includes medical information for more than 500,000 residents in Olmsted County, Minnesota, between 1966 and 2014.

The new population-based care-control study included all individuals meeting classification criteria for rheumatic diseases between 1995 and 2014.

In total, about 1,700 adults with an average age of 63 were studied. Two-thirds of the women were newly diagnosed with a systemic autoimmune rheumatic disease.

Each study participant was matched with three other people based on age at diagnosis and gender who did not have a rheumatic disease.

Upon analysis, the researchers reported that a history of sinusitis was linked to a 40% increased risk of a new diagnosis of any type of rheumatic disease. This association was strongest for antiphospholipid syndrome with a seven-fold increased risk and Sjögren’s syndrome at more than a doubled risk.

“We were not surprised by these findings,” Crowson said. “They are consistent with our findings regarding the association between other lung-related diseases and rheumatic diseases. In addition, we had previously found an association between sinusitis and rheumatoid arthritis. This study extends previous work to more rheumatic diseases.”

The scientists also discovered that the more sinusitis episodes a person had, the greater their chance of receiving a rheumatic disease diagnosis.

The researchers reported that study participants who had seven or more sinusitis episodes were twice as likely to be diagnosed with vasculitis, almost five times as likely to be diagnosed with systemic autoimmune disease, and about nine times as likely to receive a Sjögren’s syndrome diagnosis.

Sinusitis often involves bacterial pathogens, which might have a role in rheumatic disease,” Crowson explained. “In addition, sinusitis is associated with speeding up artery hardening, lending extra weight to its potential inflammatory effects. We know inflammation is related to rheumatic diseases.”

“These results point to environmental exposures that may be involved in sinusitis,” she added. “We are also interested in genetic associations. We plan to study whether the genes related to sinusitis are also related to rheumatic diseases. We also plan to study whether preventing or treating sinusitis can prevent and/or treat rheumatic diseases.”

Medical News Today also spoke with Dr. Michael Yong, an otolaryngologist (ENT) and fellowship-trained neurorhinologist at Pacific Neuroscience Institute in California who was not involved in the study.

“I think it’s a really interesting study because it sheds a little bit more light into our greater understanding that sinus pathology, nasal pathology, and upper and lower airway pathology are somewhat connected and are connected to other co-morbidities like autoimmune conditions,” Yong said.

He also said that while some of his patients with sinusitis also overlap with rheumatic diseases and autoimmune diseases, it is pretty uncommon.

“Studies like this are helpful because they shed a little bit more light on maybe, for certain patients, we should have a little bit of a higher index of suspicion that there might be something else that’s contributing to their presentation, or they might be at risk of developing something else that we should be keeping track of,” Yong said.

“This study used a retrospective database of looking at associations that may or may not be there, so they can’t really link causality,” he added. “They can’t say that sinusitis causes the autoimmune condition — more that it’s just correlated with a higher incidence of it or greater probability for these patients to develop it later on.”

“But studies like this are helpful because they give us a little bit of a starting ground to say there are some other things that we should think about that maybe we’re not concentrating on right now,” he added.

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