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118 TREATMENT OF SEVERE INFECTIOUS PURPURA IN CHILDREN WILL HUMAN PLASMA FROM DONORS IMMUNIZED WITH ESCHERICHILA COLI JS: A PROSPECTIVE, DOUBLE BLIND STUDY

Abstract

Immunotherapy with serum obtained from immunized volunteers with Escherichia Coli J5 vaccine was shown to decrease the mortality from Gram-negative shock. We analyzed the effect of anti-J5 plasma on the course and mortality of severe infectious purpura. Patients with a clinical diagnosis of sepsis wiwth purpuric lesions were enrolled if they were in shock. They received either anti-J5 plasma or control plasma. Before the administration of the plasma, 6 hours after and after 5 days of evolution, serum levels of anti-J5 antibodies, tumor necrosis factor alpha (TNF), interleukin-6 (IL-6) and elastase-al-antiprotease complexes were determined. 73 patients were randomized, 40 in the anti-J5 and 33 in the control group. Clinical and biological risk factors were similar in the two groups. However, TNF serum concentrations were 974±173pg/ml versus 473±85pg/ml, (p=0.023) and IL-6 serum concentrations were 129±45 versus 19±5ng/ml, (p=0.005) in the control group and in the treated group respectively. The duration of hypotension, of vasopressor therapy and of respiratory assistance and the occurrence of systemic complications were similar in the 2 groups. The mortality rate was 36 % in the control group and 25% in the treated group (p=0.317), (risk ratio:0.58;95% confidence interval:0.19-1.79). This trend disappeared after correction for imbalances at randomization using a logistic regression model. Anti-J5 plasma did not change the course and the mortality of severe infectious purpura in children.

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Girardin, E., Baumgartner, JD., Beaufils, F. et al. 118 TREATMENT OF SEVERE INFECTIOUS PURPURA IN CHILDREN WILL HUMAN PLASMA FROM DONORS IMMUNIZED WITH ESCHERICHILA COLI JS: A PROSPECTIVE, DOUBLE BLIND STUDY. Pediatr Res 30, 647 (1991). https://doi.org/10.1203/00006450-199112000-00148

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