IgG subclass response to gamma globulin administration in burned children

Sixteen children admitted to the North East Thames Regional Burn Unit, Billericay, were given immunoglobulin in the form of Sandoglobulin (0.3 g/kg body wt) between 36 h and 72 h after burn injury. In addition, children who developed a prodromal illness, similar to the toxic shock syndrome (TSS), prior to the administration of Sandoglobulin, were also given fresh frozen plasma and packed red blood cells where indicated. Mean serum levels of IgG1, IgG2 and IgG3 were obtained on a daily basis for the first 7 days postburn. All children survived the injury and a noticeable improvement in the clinical condition of the ill children was noted after immunoglobulin administration. A rise in serum levels of the subclasses investigated also correlated with the immunoglobulin administration and was sustained over the study period, which is the time a burned child is maximally at risk of developing TSS on our unit. There may be an 'at risk' group of children in the general population who have naturally low levels of serum IgG2.