Immunologic findings in young children with early onset of acute otitis media

Acta Otolaryngol. 2014 Oct;134(10):1022-8. doi: 10.3109/00016489.2014.902539.

Abstract

Conclusion: No significant differences in the number of immune aberrations were seen between children with or without severe recurrent acute otitis media (rAOM); however, subnormal values of immunological markers were found more often than expected, and 4 of the 60 children had treatment-requiring immune deficiencies.

Objective: Minor immunologic aberrations have been reported to be more frequent in children with rAOM. Immune investigation is recommended in children with severe rAOM, defined as six or more AOM episodes per year. The purpose of this study was to describe immunological findings in young children at high risk of developing rAOM, and to relate these to the number of expected aberrations and to the presence of severe rAOM.

Methods: A total of 109 children at risk of developing rAOM were offered immune investigation including complement function, immunoglobulins with subclasses and cellular immunity.

Results: Sixty patients were tested, 31 of whom had severe rAOM and 12 of whom did not develop rAOM. Low levels of IgG2 (27%), C1q (31%) and mannan-binding lectin (21%) were found up to eight times as often as expected. Although subnormal values were more frequent among children with severe rAOM, the study was too small to provide reliable evidence of any difference. Four children were diagnosed with immune deficiencies that required treatment.

Keywords: AOM; C1q; IgA; IgG2; MBL; Recurrent acute otitis media; rAOM; vaccination.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Acute Disease
  • Age Distribution
  • Age of Onset
  • Biomarkers / blood
  • Child, Preschool
  • Complement C3 / immunology
  • Complement C4 / immunology
  • Female
  • Follow-Up Studies
  • Humans
  • Immunity, Cellular / immunology*
  • Immunocompromised Host*
  • Immunoglobulins / blood
  • Infant
  • Logistic Models
  • Male
  • Otitis Media / diagnosis
  • Otitis Media / epidemiology*
  • Otitis Media / immunology*
  • Pneumococcal Infections / drug therapy
  • Pneumococcal Infections / immunology
  • Pneumococcal Vaccines / administration & dosage
  • Recurrence
  • Risk Assessment
  • Single-Blind Method
  • Time Factors

Substances

  • Biomarkers
  • Complement C3
  • Complement C4
  • Immunoglobulins
  • Pneumococcal Vaccines