Treatment with intravenously administered gamma globulin of chronic relapsing colitis induced by Clostridium difficile toxin

J Pediatr. 1991 Apr;118(4 Pt 1):633-7. doi: 10.1016/s0022-3476(05)83393-1.


We tested the hypothesis that children with chronic relapsing colitis induced by Clostridium difficile toxin have defective antibody responses to C. difficile toxins as a cause of their underlying illness. Six such children were tested for serum IgG and IgA antibody to C. difficile toxin A. These six children had lower IgG anti-toxin A levels than 24 healthy children (p = 0.026) and 18 healthy adults (p = 0.0008). Five patients treated with 400 mg intravenously administered gamma-globulin per kilogram every 3 weeks had significant increases in IgG (p = 0.01) but not IgA anti-toxin A (p = 0.406) levels, and all five had clinical resolution of their gastrointestinal symptoms as well as clearing of C. difficile cytotoxin B from their stools. These observations suggest that a deficiency of IgG anti-toxin A may predispose children to the development of chronic relapsing C. difficile-induced colitis. In such cases, intravenous gamma-globulin therapy may be effective in producing clinical remission.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Antibodies, Bacterial / analysis
  • Bacterial Toxins*
  • Child, Preschool
  • Chronic Disease
  • Clostridioides difficile / immunology
  • Enterocolitis, Pseudomembranous / immunology
  • Enterocolitis, Pseudomembranous / therapy*
  • Enterotoxins / immunology
  • Enzyme-Linked Immunosorbent Assay
  • Humans
  • Immunoglobulin G / administration & dosage*
  • Immunoglobulin G / therapeutic use
  • Immunoglobulins / analysis
  • Immunoglobulins, Intravenous
  • Infant
  • Recurrence


  • Antibodies, Bacterial
  • Bacterial Toxins
  • Enterotoxins
  • Immunoglobulin G
  • Immunoglobulins
  • Immunoglobulins, Intravenous
  • tcdA protein, Clostridium difficile