Immunological defects in children with chronic otitis media.

A total of 59 children with chronic otitis media were examined for possible immunological defects by determination of serum gammaglobulin and immunoglobulins IgG, IgA and IgM, and by a tuberculin test, and additionally by noting any lymphopenia. Some divergence from normal values was found in 38 patients (64%). 14 children (24%) showed pathologically low immunoglobulin levels and 7 (12%) even a subtotal absence of one of the immunoglobulin fractions. 8 of the cases (14%) also showed a reduction of gammaglobulin level. In 20 children (34%), the level of one or more of the three major Ig classes was elevated. All except one became clinically normal within a few years, showing normal gamma or immunoglobulin levels when tested. The tuberculin test was positive in all patients. The length and course of the disease in these cases was similar to that in patients with normal test values. Gammaglobulin therapy did not have any beneficail effect. Consequently, it is concluded that although humoral immunological defects may be one aetiological factor, they do not play any major role in the course of chronic otitis media in children.