Işık Yasemin BALCI, Yusuf POLAT, Meral TÜRK, Semra BALIN, Özlem ÖZLER, Kazım ATLIHAN

Talasemi majorlu çocuklarda splenektominin bazı immünolojik parametrelere etkisi

Talasemi major hastalarında enfeksiyon, mortalitenin en yaygın ikinci, morbiditenin ise en önemli sebebi olarak bilinmektedir. Bu çalışmada splenektomili ve splenektomi yapılmamış talasemi major hastalarının serum IgG, A, M düzeyleri ve akım sitometrik analiz ile periferik kandan CD4, CD8, CD3, CD19 oranları ölçülmüş, splenektominin bu parametreler üzerine etkisi araştırılmıştır.

Effects of splenectomy on the immun system in children with Thalassemia major

Infectious complications constitute the second most common cause of mortality and a main cause of morbidity in beta thalassemia major. Serum Ig G,A,M consentrations were measured in thalassemia major from patients sufferring recurrent infections. CD4, CD8, CD3, CD19 were determined in the pheripherical blood, using a flow cytometric technique. In this study, thalassemia patients were divided in two groups; splenectomized and nonsplenectomized. Immunological results were compared among them.

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1. Lanzskowsky P. Thalassemias. In: Lanzskowsky P, Editor. Manuel of Pediatric Hematology and Oncology, 4th ed. California: Elsevier Academic Pres 2005: 181-91.
2. Farmakis D, Giakoumis A, Polymeropoulos E, Aessopos A. Pathogenetic aspects of immune deficiency associated with beta-thalassemia. Med Sci Monit 2003;9: RA19-22.
3. Wiener E. Impaired phagocyte antibacterial effector functions in beta-thalassemia: a likely factor in the increased susceptibility to bacterial infections. Hematology2003;8: 35-40.
4. Moshtaghi-Kashanian GR, Gholamhoseinian A, Hoseinimoghadam A, Rajabalian S. Splenectomy changes the pattern of cytokine production in beta-thalassemic patients. Cytokine 2006;35: 253-7.
5. Pattanapanyasat K, Thepthai C, Lamchiagdhase P, Lerdwana S, Tachavanich K, Thanomsuk P, et al. Lymphocyte subsets and specific T-cell immune response in thalassemia. Cytometry2000;15: 42: 11-7.
6. Constantoulakis M, Trichopoulos D, Avgoustaki O, Economidou J. Serum immunoglobulin concentrations before and after splenectomy in patients with homozygous beta-thalassaemia. J Clin Pathol 1978;31: 546-50.
7. Quintiliani L, Mastromonaco A, Giuliani E, Buzzonetti A, Sisti P, Guglielmetti M, et al. Immune profile alterations in thalassaemic patients. Boll Ist Sieroter Milan 1983;62: 524-30.
8. Vergin C, Kutukculer N, Cetingul N, Nisli G, Caglayan S, Oztop S. Serum immunoglobulins, IgG subclasses, isohemagglutinins and comple-ment-3 levels in patients with thalassemia major. Indian J Pediatr1997;64: 215-9.
9. Koren A, Haasz R, Tiatler A, Katzuni E. Serum immunoglobulin levels in children after splenectomy. A prospective study. Am J Dis Child 1984;138: 53-5.
10. Khalifa AS, Fattah SA, Maged Z, Sabry F, Mohamed HA. Immunoglobulin levels, opsonic activity and phagocytic power in Egyptian thalassemic children. Acta Haematol 1983;69: 136-9.
11. Tovo PA, Miniero R, Barbera C, Sacchetti L, Saitta M. Serum immunoglobulins in homozygous beta-thalassemia. Acta Haematol1981; 65: 21-5.
12. Dwyer J, Wood C, McNamara J, Williams A, Andiman W, Rink L et al. Abnormalities in the immune system of children with beta-thalassaemia major. Clin Exp Immunol. 1987;68: 621-9.
13. Lombardi G, Matera R, Minervini MM, Cascavilla N, D'Arcangelo P, Carotenuto, M et al. Serum levels of cytokines and soluble antigens in polytransfused patients with beta-thalassemia major: relationship to immune status. Haematologica1994;79: 406-12.
14. Ezer U, Gülderen F, Culha VK, Akgül N, Gürbüz O. Immunological status of thalassemia syndrome. Pediatr Hematol Oncol2002;19: 51-8.
15. Guglielmo P, Cunsolo F, Lombardo T, Sortino G, Giustolisi R, Cacciola E, et al. T-subset abnormalities in thalassaemia intermedia: possible evidence for a thymus functional deficiency. Acta Haematol 1984; 72: 361-7.
16. Boonpucknavig S, Chiewsilp P, Isarangkura P, O'Charoen R, Akkawat R. Immunologic reactivity in thalassemia. Birth Defects Orig Artic Ser1987;23: 565-9.
17. Grady RW, Akbar AN, Giardina PJ, Hilgartner MW, de Sousa M. Disproportionate lymphoid cell subsets in thalassaemia major: the relative contributions of transfusion and splenectomy. Br J Haematol 1985;59: 713-24.