Prevention of pneumococcal infection in a patient with normal immunoglobulin levels but impaired polysaccharide antibody production.
BACKGROUND
Patients with normal immunoglobulin levels may have an impaired response to immunization with pneumococcal vaccine and increased susceptibility to infection with encapsulated organisms. In children, but not adults, immunoglobulin replacement has been shown to be effective in reducing the infection rate.


OBJECTIVE
To reduce the incidence of infection in an adult with impaired response to pneumococcal vaccine but normal serum IgG levels.


METHODS
Intravenous IgG, 350 mg/kg, was given every 4 weeks.


RESULTS
The patient, who was hospitalized 3 times in 3 years with respiratory tract infections and who had documented infection with Streptococcus pneumoniae and Haemophilus influenzae, did not require antibiotic therapy for more than 15 months while undergoing intravenous immunoglobulin replacement therapy.


CONCLUSIONS
Adults with impaired response to vaccination with polyvalent pneumococcal vaccine and normal IgG levels may benefit from replacement therapy.
Cohn
Joshua A
JA
University of Michigan Medical School, Ann Arbor, Michigan, USA. john.cohn@mail.tju.edu
Skorpinski
Edward
E
Cohn
John R
JR
D000368:Aged; D000907:Antibodies, Bacterial / Q000097:blood; D005260:Female; D006801:Humans; D007116:Immunization, Passive / Q000379:methods*; D007136:Immunoglobulins / Q000097:blood* / Q000276:immunology; D007153:Immunologic Deficiency Syndromes / Q000276:immunology / Q000628:therapy; D011008:Pneumococcal Infections / Q000097:blood / Q000276:immunology / Q000517:prevention & control*; D022242:Pneumococcal Vaccines / Q000276:immunology / Q000627:therapeutic use; D011018:Pneumonia, Pneumococcal / Q000188:drug therapy / Q000276:immunology / Q000517:prevention & control; D011135:Polysaccharides, Bacterial / Q000276:immunology*; D013296:Streptococcus pneumoniae / Q000276:immunology
D000907:Antibodies, Bacterial; D007136:Immunoglobulins; D022242:Pneumococcal Vaccines; D011135:Polysaccharides, Bacterial