[Sensible immunologic diagnosis and therapy in children with recurrent infections]

This retrospective study of immunological findings in 108 children with various infections shows that the majority of patients were younger than 6 years of age. In the main, the study resulted in the following immunological findings. In children with recurrent infections of the lower respiratory tract, there was the notable selective IgA deficiency, much more common than in the rest of the population. Children with otitis and pyogenic infections of the skin, which are mainly bacterial infections, had in particular a low number of anti-bacterial antibodies and were lacking in opsonins. This missing opsonization was significantly higher (p greater than 0,05) in children with recurrent otitis than in the other patients. Anti-bacterial antibodies and osponization of bacteria are only present in effective numbers from the age of about 3 in 90% of healthy children. Patients over 3 with various recurring infections had, in comparison to healthy children, significantly higher numbers a reduced ability to opsonize (p less than 0,00001) or a lack of antibodies (p less than 0,05). These deficiencies occurred separately. Children with infections of the upper respiratory tract or polytope infections had no characteristic deficiencies. In children with a recurring tendency to infection, there are 3 important factors to consider for a meaningful diagnosis and therapy: age, type of illness and the epidemiological situation of the child. If these factors are taken into consideration, the decision as to whether, when and what kind of an immunological test should be carried, is facilitated. The therapy is then also more effective and more selective.