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Urticaria and Sinusitis-Reply

Kraig W. Jacobson, MC; Leslie Bernard Branch, MC; Harold S. Nelson, MC
JAMA. 1981;245(1):29-30. doi:10.1001/jama.1981.03310260013008.
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In Reply.—  Referring to the letter by Dr Altman, in the 64 patients with chronic urticaria who had sinus x-ray examinations, there were abnormal radiological findings interpreted as sinusitis in 11 cases; three suggested chronic and eight acute involvement. The three cases interpreted as having chronic sinusitis all had substantial bilateral mucosal thickening of the maxillary sinuses, and one, in addition, had involvement of the ethmoid sinuses. The eight patients thought to have radiological evidence of acute sinusitis all had air-fluid levels in the maxillary sinuses. In one patient, the findings were bilateral; in seven, unilateral.We certainly agree that the literature cited by Dr Ravenel indicates that unsuspected abnormal radiological findings of the sinuses are encountered in asymptomatic young children. However, these studies have limited relevance to our article. Our study was intended to show a costbenefit effectiveness of a number of laboratory tests employed in the evaluation of


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