Source: Annual Congress 2001 - Immune deficiencies and the lung in childhood
Disease area: Paediatric lung diseases, Respiratory infections

Abstract

IgG subclass deficiency and/or a decreased humoral immune response to pneumococcal polysaccharide antigens (Ag) are common findings in children with recurrent respiratory tract infections.
This study is a retrospective analysis of the effect of IVG in 26 children (14 boys) with a humoral immunodeficiency and at least 6 infections a year needing antibiotic treatment without improvement. Twenty two were deficient in IgG2 subclass with a combined immune deficiency in 7 of them, one was IgG3 and two had a decreased antibody response to polysaccharide Ag. IVG (400mg/kg) was administered monthly during 6 or 12 months.
Clinical improvement was seen in 23 children (88%). Twenty two patients suffered from recurrent respiratory infections. One child showed recurrent periods of fever and diarrhea. One group (9 children (39%)) showed a significant reduction of the number of infections during (median 12 vs. 2, P<.001) and 6 to 12 m after the end of IVG therapy (median 12 vs. 2, P<.001). The recurrent infections appeared at the mean age of 1y8m (6m-4y). IVG therapy was started at the mean age of 2y11m(15m-5y5m). A second group (14 children (61%)) showed a reduction of infections only during the IVG therapy (median 12 vs.2, P<.001). Symptoms appeared at the mean age of 3y4m (4m-10y). IVG therapy was started at the mean age of 5y6m (6m-12y).
Our findings suggest a significant protective effect of IVG therapy in children with humoral immune deficiencies. In younger children a more persistant clinical improvement was observed, suggesting a transient immaturity of the immune system. In older children the post treatment effect was less pronounced, suggesting a true humoral immune deficiency.


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Citations should be made in the following way:
F. Haerynck, S. Van Daele, P. Schelstraete, F. De Baets (Ghent, Belgium). Treatment with intravenous immunoglobulin (IVG) in children with humoral immune deficiencies and recurrent respiratory tract infections. Eur Respir J 2001; 16: Suppl. 31, 3436

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