Familial risk of pediatric chronic rhinosinusitis

Objectives/HypothesisTo determine the risk of chronic rhinosinusitis (CRS) in relatives of children with a diagnosis of CRS. Study DesignRetrospective observational cohort study with population-based matched controls. MethodsA unique genealogical database linked to medical records was used to identify subjects 12 years old with a diagnosis of CRS from 1996 to 2011. The familial recurrence risks of CRS in first- through fifth-degree relatives of probands were calculated using Cox models and compared to controls randomly selected from the Utah population and matched 10:1 on sex and birth year. ResultsWe identified 496 pediatric patients with CRS. Siblings of patients with CRS demonstrated a 57.5-fold increased risk (P<10(-8)) of also having pediatric CRS. First cousins had a 9.0-fold increased risk (P<10(-3)) and second cousins had a 2.9-fold increased risk (P=.002) of pediatric CRS. First-degree relatives, second-degree relatives, and first cousins of pediatric cases demonstrated a significant increased risk of having adult CRS. Parents of probands demonstrated a 5.6-fold increased risk (P<10(-15)). Fifty-five probands had one affected parent versus three probands with two affected parents. ConclusionsIn the largest population study to date of children with CRS, a significant familial risk is confirmed. Parents of probands were also at increased risk, although it was much more likely for one parent to be affected than both, suggesting a genetic component of the disease. Further understanding of the genetic basis of CRS and its interplay with environmental factors could clarify the etiology and lead to more effective targeted treatments.