[The application of immunoglobulins for intravenous administration for the combined treatment of paratonsillar abscesses].

The objective of the present study was to evaluate the possibility of using immunoglobilins for intravenous administration (IVIG) to treat the patients presenting with paratonsillar abscesses (PTA). The comparative assessment of the clinical and immunological status of 77 patients with PTA depending on the type of therapy (traditional or combined with the use of IVIG) and the occurrence of tonsillitis in the medical history (the newly diagnosed disease, frequent tonsillitis, relapses of PTA). The level s of immunoglobulins (sIgA, IgA, IgG and its subclasses, IgM, and IgE) in mixed saliva samples were determined by the immunoenzyme assay and the albumin level by the bromcresol method with the counting of relative secretion coefficients (RSC). Palatine tonsil (PT) biopsies were used to determine the absolute content of lymphocytes (Lf) that were classified into differentiation clusters (CD3, CD4, CD8, CD16, CD25, CD71, CD95, HLA-DR). The patients presenting with paratonsillar abscesses were characterized by impaired immune responsiveness of palatine tonsils manifest as reduced production of IgG (at the expense of IgG2). This reduction was especially pronounced in the cases with the burdened medical history (recurring tonsillitis and relapses of PTA). In such patients, traditional therapy resulted in suppression of the cellular component of immunity and IgG production. The treatment with IVIG increased the production of IgG antibodies in the patients with newly diagnosed tonsillitis; moreover it stimulates production of IgG and activated the T-cell component. At the same time, the administration of IVIG reduced the duration of hospital stay from 9.29±0.31 to 7.06±25 days and the number of PTA relapses. It is concluded that the low IgG content in the saliva may be an indication for tonsillectomy.