Oral immunoglobulins for treatment of acute rotaviral gastroenteritis

Oral administration of immunoglobulin may be effective in the treatment of acute rotaviral gastroenteritis in children. Rotavirus infection is the most frequent cause of gastroenteritis, resulting in severe diarrhea. The only therapy to date is oral rehydration. A total of 71 children with acute rotavirus gastroenteritis were divided into two groups. Group A received a single oral dose of 300 milligrams per kilogram of body weight of immunoglobulin and group B received a single oral dose of a glucose solution. After receiving treatment, children in group A had faster recoveries than those in group B. A significant reduction in bowel movements was observed in group A during the four days after therapy compared to group B. Apparently, immunoglobulin reduced the duration of diarrhea in group A. No side effects were noted during the study. Physicians should use immunoglobulin therapy to treat children hospitalized with acute rotaviral gastroenteritis.
ABSTRACT. Objective. Preliminary evidence has been reported on the antirotavirus effect of human serum immunoglobulin administered orally. The aim was to see whether such treatment might be effective in rotavirus acute gastroenteritis. Methods. A prospective, double-blind, placebo-controlled study was performed. Ninety-eight children admitted with acute gastroenteritis were enrolled and randomly assigned to groups A (treated) and B (control). Children in group A received a single oral dose of 300 mg/kg body weight of human serum immunoglobulin. Parameters of efficacy were clinical condition, frequency and consistency of stools, duration of diarrhea, duration of viral excretion, and length of hospital stay. Antirotaviral activity was determined in the immunoglobulin preparation by a specific neutralization assay. Results. Seventy-one of the 98 children enrolled had rotaviral gastroenteritis; 36 belonged to group A. Children who received immunoglobulin had significantly faster clinical improvement of clinical condition and stool pattern than control children. Mean total duration of rotaviral diarrhea was 76 hours in group A and 131 in group B (P < .01). Viral excretion lasted 114 and 180 hours, respectively (P< .01). Hospital stay was significantly reduced in children in group A. Neutralizing antibodies against rotavirus were detected in the immunoglobulin preparation. Conclusion. Oral administration of immunoglobulin is associated with a faster recovery from acute gastroenteritis and should be given to children hospitalized with this illness. Pediatrics 1994;93:12-16; immunoglobulin, gastroenteritis, rotavirus, diarrhea.