SUCCESSFUL INTRAVENOUS IMMUNOGLOBULIN THERAPY FOR RECURRENT PNEUMOCOCCAL OTITIS-MEDIA IN YOUNG-CHILDREN

Serum immunoglobulin levels and naturally occurring antibody titres ag ainst Streptococcus pneumoniae were measured in seven children aged 1- 1.9 years with recurrent pneumococcal acute otitis media (AOM). Three of them had low IgG(2) levels. Mean antibody levels of antipneumococca l IgG(1) and anti-pneumococcal IgG(2) were significantly lower in pati ents when compared to those of healthy controls and children who had l ess frequent episodes of AOM. Following treatment with intravenous imm unoglobulin (IVIG) for 6 months, anti-pneumococcal IgG(1) and IgG(2) a ntibody levels increased and the number of episodes of AOM decreased i n ah patients. Following the discontinuation of IVIG therapy, no AOM e pisode occurred. Serum levels of anti-pneumococcal IgG(1) and IgG(2) w ere normal, which were measured in three subjects at 5, 6, and 12 mont hs after the cessation of IVIG therapy. These results suggested that d elayed maturation of anti-pneumococcal antibody production caused recu rrent AOM and this condition was corrected by IVIG therapy.