Leung D Y, Kelly C P, Boguniewicz M, Pothoulakis C, LaMont J T, Flores A
Division of Pediatric Allergy-Immunology, National Jewish Center for Immunology and Respiratory Medicine, Denver, Colorado 80206.
J Pediatr. 1991 Apr;118(4 Pt 1):633-7. doi: 10.1016/s0022-3476(05)83393-1.
We tested the hypothesis that children with chronic relapsing colitis induced by Clostridium difficile toxin have defective antibody responses to C. difficile toxins as a cause of their underlying illness. Six such children were tested for serum IgG and IgA antibody to C. difficile toxin A. These six children had lower IgG anti-toxin A levels than 24 healthy children (p = 0.026) and 18 healthy adults (p = 0.0008). Five patients treated with 400 mg intravenously administered gamma-globulin per kilogram every 3 weeks had significant increases in IgG (p = 0.01) but not IgA anti-toxin A (p = 0.406) levels, and all five had clinical resolution of their gastrointestinal symptoms as well as clearing of C. difficile cytotoxin B from their stools. These observations suggest that a deficiency of IgG anti-toxin A may predispose children to the development of chronic relapsing C. difficile-induced colitis. In such cases, intravenous gamma-globulin therapy may be effective in producing clinical remission.
由艰难梭菌毒素引起的慢性复发性结肠炎患儿对艰难梭菌毒素的抗体反应存在缺陷，这是其潜在疾病的病因。对6名此类患儿进行了针对艰难梭菌毒素A的血清IgG和IgA抗体检测。这6名患儿的IgG抗毒素A水平低于24名健康儿童（p = 0.026）和18名健康成人（p = 0.0008）。5名每3周静脉注射每千克400毫克丙种球蛋白的患者，其IgG（p = 0.01）水平显著升高，但IgA抗毒素A水平（p = 0.406）未升高，且所有5名患者的胃肠道症状均有临床缓解，粪便中的艰难梭菌细胞毒素B也清除。这些观察结果表明，IgG抗毒素A缺乏可能使儿童易患慢性复发性艰难梭菌诱导的结肠炎。在这种情况下，静脉注射丙种球蛋白治疗可能有效实现临床缓解。
