Treatment with intravenously administered gamma globulin of chronic relapsing colitis induced by Clostridium difficile toxin

A study was carried out of six children with chronic relapsing colitis (inflammation of the large bowel) due to Clostridium difficile, an infectious organism. The children had undergone antibiotic treatment before the study began. Chronic relapsing colitis may result, in some cases, from patients' abnormally low levels of antibodies against toxin A, one of two toxins produced by Clostridium difficile. To learn more about this possibility, blood tests were carried out on the six patients, 24 healthy children, and 18 healthy adults. Results showed that patients' levels of IgG antibodies (a type of antibody) against toxin A were lower than the levels in control children or adults. Five children were treated with intravenously administered gamma globulin (IVGG, an infusion containing antibodies); during this time, no antibiotics were given. This led to a reduction in the frequency of bowel movements and to the elimination of symptoms of colitis in four patients even after IVGG therapy stopped. It is likely that colitis caused by toxins released by Clostridium difficile developed in these patients as a complication of antibiotic treatment of upper respiratory tract infections. IVGG therapy appears effective for treating chronic relapsing colitis due to Clostridium difficile, particularly in patients who have low levels of IgG antibodies against toxin A. (Consumer Summary produced by Reliance Medical Information, Inc.)