Successful intravenous immunoglobulin therapy for recurrent pneumococcal otitis media in young children

Serum immunoglobulin levels and naturally occurring antibody titres againstStreptococcus pneumoniae were measured in seven children aged 1–1.9 years with recurent pneumococcal acute otitis media (AOM). Three of them had low IgG₂ levels. Mean antibody levels of anti-pneumococcal IgG₁ and anti-pneumococcal IgG₂ were significantly lower in patients when compared to those of healthy controls and children who had less frequent episodes of AOM. Following treatment with intravenous immunoglobulin (IVIG) for 6 months, anti-pneumococcal IgG₁ and IgG₂ antibody levels increased and the number of episodes of AOM decreased in all patients. Following the discontinuation of IVIG therapy, no AOM episode occurred. Serum levels of anti-pneumococcal IgG₁ and IgG₂ were normal, which were measured in three subjects at 5,6, and 12 months after the cessation of IVIG therapy. These results suggested that delayed maturation of anti-pneumococcal antibody production caused recurrent AOM and this condition was corrected by IVIG therapy.