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September 1980

Cell-Mediated Immune Defects and Infection: A Study of Malnourished Hospitalized Children

Author Affiliations

From the Divisions of Immunology (Drs Warner, Borut, and Stiehm), Gastroenterology (Drs Byrne and Ament), and Infectious Diseases (Drs Carney and Cherry), Department of Pediatrics, UCLA School of Medicine, Center for the Health Sciences, Los Angeles.

Am J Dis Child. 1980;134(9):824-827. doi:10.1001/archpedi.1980.02130210008003

• Severe protein calorie malnutrition in children in developing countries has been characterized by noticeable depression of cell-mediated immunity and an increased manifestation of infectious illnesses. We studied 23 hospitalized US children whose admitting diagnoses included severe malnutrition to see if similar findings existed. Children were divided into two groups based on the percentage of E rosettes (T cells) prior to nutritional therapy. Those with E rosette values less than 50% were considered to have noticeably abnormal cell-mediated immunity. Eleven of the 23 patients who had rosette values less than 50% had 18 clinical infections, including four episodes of sepsis. One of the 23 children with normal (>50%) E rosettes had one minor infection. It was concluded that depressed cellular immunity as measured by E rosettes is associated with an increased incidence of infectious illness in the malnourished hospitalized pediatric patient in the United States. Other defects in host defenses, ie, defects in complement and phagocytic function, may also have contributed to the increased number of clinical infections noted in these patients.

(Am J Dis Child 134:824-827, 1980)

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