Immunologic screening of children with recurrent otitis media
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Published on: January 23, 2017
Selma P Wiertsema1, Reinier H Veenhoven, Elisabeth A M Sanders
1Department of Immunology, University Medical Center Utrecht, Wilhelmina Children's Hospital, KC03.063.0, Lundlaan 6, 3584 EA Utrecht, The Netherlands.
Insights
Recurrent otitis in children may indicate underlying immune deficiencies, such as low immunoglobulin A or IgG2 levels. Identifying these immune defects can guide effective treatment for frequent ear infections.
Area of Science:
- Pediatrics
- Immunology
- Otolaryngology
Background:
- Otitis media affects 5-10% of infants and toddlers annually.
- While often temporary, recurrent or complicated otitis can signal underlying issues.
Purpose of the Study:
- To investigate the role of immunologic screening in children with frequent otitis.
- To identify specific immune deficiencies associated with recurrent otitis.
Main Methods:
- Review of cases with frequent or complicated otitis.
- Immunologic screening including immunoglobulin levels (IgA, IgG subclasses).
- Assessment of specific antibody response to bacterial polysaccharides.
Main Results:
- Agammaglobulinemia/hypogammaglobulinemia are rare.
- Common findings include deficient immunoglobulin A or decreased IgG2 subclass levels.
- Disturbed specific antibody response to bacterial capsular polysaccharides is frequent.
Conclusions:
- Immunologic screening is crucial for children with persistent or complicated otitis.
- Identifying immunoglobulin deficiencies (IgA, IgG2) and impaired antibody response aids treatment decisions.
- Early detection of immune defects can improve management of recurrent otitis.
Abstract:
Some 5% to 10% of all infants and toddlers suffer from four or more episodes of otitis per year. Usually, this is a temporary problem that resolves with increasing age. In a minority of cases, otitis episodes are frequent or have an abnormal course, with complications such as mastoiditis. In these cases, immunologic screening is indicated, to exclude an immunodeficiency. Agammaglobulinemia or hypogammaglobulinemia is rare among these patients. Other immune defects that occur more often are deficient or lowered immunoglobulin (Ig)A or decreased levels of one or more IgG subclass, in particular IgG2. The specific antibody response to bacterial capsular polysaccharides often is disturbed. These findings can give direction to the treatment of children with frequent, recurrent otitis.
