Discussion
Oral immunoglobulins have reported use in low birth
weight infants and children.8 A study of children aged
two to 36 months prescribed immunoglobulin as a
single 300 mg/kg oral dose for rotaviral gastroenteritis.9
Seventy-one children were randomized prospectively to
receive oral immunoglobulin or placebo 5% glucose
solution. A statistically significant improvement in
stool frequency and stool consistency was observed
for patients treated with oral immunoglobulin, as compared
to the control patients.
A published trial of adult and pediatric HSCT
patients with rotavirus illness was used as historical
controls for our study. The duration of symptoms in
this patient group was reported as four days to four
months, with 42% of patients remaining symptomatic
for greater than two weeks.6 In our study, the time to
rotavirus symptom resolution was decreased, compared
this published cohort, and improvement in stool frequency
and consistency was observed in three of four
courses.
Rotavirus infects intestinal epithelial cells and
induces cytotoxic changes of intestinal villi and loss of
tissue integrity. Rotavirus infection also causes
decreased absorption of electrolytes at the intestinal
level. The impact of intestinal chloride and calcium
secretion and cell damage at the level of the enterocyte
are noted as the mechanism for rotavirus-induced diarrhea.
Human serum IgG reduces the toxic effect on
enterocytes during rotavirus infection.