Hasibe ARTAÇ, Reyhan KARA, İsmail REİSLİ, Sevgi KELEŞ

Değişken immün yetersizlikli çocuk hastalarda klinik ve laboratuvar özellikler

Değişken immün yetersizlik (DİY), bozulmuş antikor yanıtı ile belirgin, nedeni bilinmeyen birincil bir immün yetersizliktir. Bu çalışmanın amacı, DİY'li çocuk hastaların klinik ve laboratuvar özelliklerinin değerlendirilmesidir. Gereç ve Yöntem: Şubat 2002-Haziran 2006 tarihleri arasında, ortalama 29,7±17,4(2-51) ay, DİY tanısıyla takip ve tedavi edilen 10 çocuk hastanın dosya kayıtları gözden geçirildi. Bulgular: Hastaların yedisi kız, üçü erkek olup, tanı yaşları ortalama 9,4±5,1 (3-18) yıldı. Hastaların hepsi tekrarlayan alt solunum yolu enfeksiyonu nedeniyle başvurmuşlardı. Dokuz olguda kronik akciğer hastalığı mevcuttu ve bunların üçü lobektomi geçirmişti. Dört hastanın IgG düzeyi 200 mg/dl'nin altındaydı. Altı hastada en az iki immünglobulin düzeyinde azalma vardı. IgG düzeyi normal olan dört olgunun ikisinde IgA düşüklüğü ve diğer ikisinde ise IgM düşüklüğü saptandı. Tüm hastaların tanı anında B lenfosit oranı düşük bulundu (%1,6-8,9; 5,3±2,8). Sekiz olguda CD4/CD8 oranı tersine dönmüştü. Çıkarımlar: "Heterojen" bir immün yetersizlik olan bu hastalığın kronik akciğer hastalığı olan olgularda araştırılması gerektiğini düşünüyoruz.

Clinical and laboratory features in pediatric patients with common variable immunodeficiency

Aim: Common variable immunodeficiency (CVID) is a primary immunodeficiency disease characterized by defective antibody production and heterogeneous clinical features. We aimed to describe clinical and laboratory features of our patients with CVID. Materail and Method: We restrospectively evaluated the records of children diagnosed with CVID from February 2002 to June 2006 and followed-up for mean of 29.7±17.4 (2-51) months. Results: A total of 10 patients, 7 females and 3 males (mean age: 9.4±5.1, ranging from 3 to 18) were included in this study. All of them were admitted to our clinic due to recurrent bronchopneumonia. Nine patients had chronic pulmonary disease at the time of CVID diagnosis and lobectomy had been performed in three patients. Serum IgG concentrations were less than 200 mg/dl in four patients. There was a reduction of at least two serum immunoglobulin levels in six patients. Four patients had normal IgG levels, but two of them had decreased IgM levels and the other two had decreased IgA levels. The percentages of B cells was found to be low (% 1.6-8.9; 5.3+2.8) in all of the patients. The inversion in the CD4/CD8 ratio was observed in the peripheral blood lymphocytes of eight patients. Conclusions: We suggested that CVID should be especially investigated in patients with chronic pulmonary disease.

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