title: Recurrent acute epiglottitis in adults: defective antibody response.
abstract: BACKGROUND
  Recurrent acute epiglottitis is uncommon in adults. In the medical literature, very little is known about the immune status of this population.
  
  
  OBJECTIVE
  To evaluate the immune system of a group of four adult patients with recurrent acute epiglottitis, in what represents the largest series ever reported.
  
  
  METHODS
  The clinical course of these episodes was carefully evaluated and a basic immune deficiency work-up was carried out for each patient.
  
  
  RESULTS
  All four patients displayed clinical and laboratory evidence of impaired humoral immunity. One patient was splenectomized. Another patient had a below normal immunoglobulin G level. At the time of their first evaluation, none of our patients had specific antibodies against Haemophilus influenzae and one had a subnormal Streptococcus pneumoniae immunoglobulin G level for a majority of serotypes. After specific vaccination, two patients had persistent abnormalities in their response to one or more polysaccharides or conjugate-polysaccharide antigens. In the other two, the transient abnormalities were corrected by immunization.
  
  
  CONCLUSIONS
  When recurrent acute epiglottitis occurs in adults, it is important to investigate the immune system because a quantitative or a specific antibody deficiency could be found. It also follows that these patients will be successfully treated either by immunization or antibody replacement.
authors.affiliation: Allergy and Immunology Department, Centre Hospitalier Université Laval, Sainte-Foy, Québec, Canada.
authors.forename: Rémi
authors.initials: R
authors.lastname: Gagnon
authors.forename: Pierre-Michel
authors.initials: PM
authors.lastname: Bédard
authors.forename: Louise
authors.initials: L
authors.lastname: Côté
authors.forename: Aubert
authors.initials: A
authors.lastname: Lavoie
authors.forename: Jacques
authors.initials: J
authors.lastname: Hébert
mesh_terms: D000208:Acute Disease; D000328:Adult; D000907:Antibodies, Bacterial / Q000097:blood; D000917:Antibody Formation; D004826:Epiglottitis / Q000097:blood / Q000276:immunology* / Q000517:prevention & control*; D018073:Haemophilus Vaccines / Q000008:administration & dosage; D006193:Haemophilus influenzae / Q000276:immunology; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D008297:Male; D022242:Pneumococcal Vaccines / Q000008:administration & dosage; D012008:Recurrence; D013156:Splenectomy; D013296:Streptococcus pneumoniae / Q000276:immunology; D014611:Vaccination
chemical_list: D000907:Antibodies, Bacterial; D018073:Haemophilus Vaccines; D007074:Immunoglobulin G; D022242:Pneumococcal Vaccines