EFFECTS OF HIGH-DOSE INTRAVENOUS IMMUNE GLOBULIN THERAPY IN MODERATE OR SEVERE ASTHMATIC CHILDREN WITH RECURRENT INFECTIONS

Abstract

Nineteen pediatric patients aged 0-7years with moderate or severe asthma and recurrent infections were enrolled in an open-label trial of high-dose intravenous immune globulin (IVIG), 400mg/kg/day for 5 days. We evaluated the symptoms in each patient at 2 weeks prior to the trial, and at 1 month, 7 months and 2 years from the trial.
Seventeen of the 19 cases completed this trial at 7 months and six at 2 years.
The 17 cases recorded their daily symptoms, ADL (Activities of Daily Living) and medicines taken. The number of asthma attacks and the ADL score were both decreased after the last infusion and further improved after 7 months. Other symptoms were also improved, but moderately. Severity of asthma was improved to 70.6% (12/17) after 7 months and still 50.0% (3/6) after 2 years. The number of admissions was also decreased from 1.5 times in 7 months, just after the trial, to 0.3 times in 6 months between 1.5 and 2 years after.
The clinical symptoms improved in 58.8% (10/17) after the last infusion and in 76.5% (13/17) after 7 months. Clinical symptoms considering the medicine scores were improved in 64.7% (11/17) after 1 month and 82.3% (14/17) after 7 months.
Twelve of the 19 cases complained of fever, vomiting, headache and/or nausea but only for a while during the first couple of days.
Occurrence of pneumoniae and bronchitis was reduced from 94% (16/17) before the trial to 18% (3/17) after 1 months, and to same degree up to 7 months.
Clinically, the children under 3 years old improved better than those over 3 years old. Especially the children whose eosinophil count levels were high under 3 years old improved remarkably.
According to this investigation, each IgG subclass in immune globulin was considered to act immunologically as a regulator.