Immunoglobulins in children with autoimmune diabetes mellitus

In this paper we review the results of six studies, published between 1985 and 1993, which report on immunoglobulin treatment in children with idiopathic diabetes mellitus (IDDM). A total of 77 children with newly diagnosed IDDM were infused with high dose gammaglobulin, while 56 patients were not infused and served as controls. Clinical outcome as judged by the rate of induction and duration of remission, insulin requirement, metabolic control (HbAlc) and C-peptide were determined. Side effects of treatment with 0.4 g gammaglobulin/kg bw/day were minimal, and were remarkable with 2 g/kg bw/day as single doses. No significant differences between the treated and control IDDM children were observed in metabolic control or C-peptide release, while the insulin requirement was significantly less in 2 studies during immunoglobulin therapy. In all 6 studies a subgroup of patients showed some benefit from treatment, with higher rates and longer durations of remissions and preserved C-peptide release. However, no guidelines can be offered at this point for those patients who may possibly benefit from immunoglobulin therapy.