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November 1986

Lymphocyte Subpopulations and Corticosteroid Treatment in Patients With Pertussis

Author Affiliations

Division of Infectious Diseases and Blood and Immunohematology Center Varese General Hospital 21100 Varese, Italy

Am J Dis Child. 1986;140(11):1094. doi:10.1001/archpedi.1986.02140250020011

Sir.—Immunity in pertussis has not yet been clarified; local immunity probably plays an important role, as Bordetella pertussis causes a noninvasive infection that is restricted to the ciliated respiratory epithelial cells. On the other hand, a toxin produced by B pertussis, lymphocytosispromoting factor, is responsible for systemic manifestations. Hewlett et al1 showed that B pertussis causes an impairment of cell-mediated immunity in children that is reversible with recovery. The use of corticosteroids in pertussis remains controversial; Zoumboulakis et al2 and Chandra et al3 demonstrated a beneficial effect of corticosteroids in reducing the severity and the number of attacks of whooping; however, corticosteroids can impair cellular immunity and could lead to severe complications.

Patients and Methods.—To analyze the role of B pertussis and corticosteroid treatment, we examined T-lymphocyte subpopulations of 11 patients with pertussis. Patients were admitted to our division with the diagnosis of pertussis based