Treatment of severe pertussis by administration of specific gamma globulin with high titers anti‐toxin antibody

Abstract

Our patient presented with severe respiratory distress and marked pleocytosis. She was mechanically ventilated and received gamma globulin with high titers of anti-pertussis toxin and anti-filamentous hemagglutinin. Her clinical signs improved and a notable decrease in white blood cell count was observed. Ten months after treatment, the patient showed normal physical and mental development and anti-pertussis toxin and anti-filamentous hemagglutinin titers were significantly increased. Recently, the effectiveness of gamma globulin therapy has been emphasized again. Our experience supports the use of iv gamma globulin infusion. Also, gamma globulin did not influence the patient's own immunologic response to pertussis. Gamma globulin therapy with high anti-pertussis toxin titers could be considered for treatment of severe pertussis.

Pertussis: a concise historical review including diagnosis, incidence, clinical manifestations and the role of treatment and vaccination in management

“…Human hyperimmune pertussis globulin is still used occasionally [90,91]. Further treatment is symptomatic.…”

Current Practices of Adjunctive Therapy for Pertussis at Six Canadian Tertiary Care Pediatric Hospitals

“…However, because of small sample sizes, different drugs and varying dosage regimens, confirmatory studies are required to determine the efficacy of steroids in the management of pertussis. Other investigational therapies, such as intravenous pertussis immune globulin (19)(20)(21), require further demonstration of effectiveness before they can be widely recommended.…”

Caso clínico-radiológico

“…Estudios posteriores indicaron que la gammaglubilina utilizada presentaba baja concentración de anticuerpos específicos antitoxina. En un estudio murino usando gammaglobulina hiperinmune se logró mayor sobrevida y disminución de los síntomas, además de reducción en el recuento leucocitario, por lo tanto se debe usar esta inmunoglobulina y no la standard (17)(18)(19)(20)(21)(22)(23)(24)(25) .…”