Systemic Immune Functional Study in Biliary Atresia Children with Cholestatic Jaundice: Clinical Implication
Date Issued
2006
Date
2006
Author(s)
DOI
zh-TW
Abstract
Biliary atresia (BA) is one of the most common cholestatic liver diseases in early infancy. Early diagnosis with Kasai operation performed before the age of 60 days old is an important prognostic factor. However, about one-third of patients with biliary atresia remain jaundiced even after prompt intervention, and another one-third again become jaundiced after recurrent episodes of ascending cholangitis.
To investigate the association between chronic cholestatic jaundice, systemic immunity, and various infectious complications in patients with biliary atresia, we performed a survey of the systemic immune function in 30 children with biliary atresia. Patients were divided into a jaundice group (total serum bilirubin above 2 mg/dL for more than 6 months) and control group (total serum bilirubin below 2 mg/dL for more than 6 months) with comparable age. Patients were tested for serum immunoglobulin and complement levels, mitogen response, interleukin-4, interleukin-5, and interferon-gamma production after phytohemagglutinin stimulation, blood cell and lymphocyte subpopulation counts, phagocytic function, and leukocyte adhesion complex. They were then followed prospectively for 6 months, and severe infectious complications requiring hospitalization were recorded.
Compared to jaundice-free patients, T-lymphocyte proliferation function, determined by phytohemagglutinin mitogen test was significantly lower (p = 0.02) in biliary atresia patients with chronic cholestatic jaundice after Kasai operation. There is no obvious difference in the humoral and non-specific cellular immune function between these two groups. During the study period, patients with chronic cholestatic jaundice had a higher risk of severe infectious complications than their jaundice-free counterparts (risk ratio = 5.87; p = 0.001).
In conclusion, biliary atresia patients with chronic cholestatic jaundice are associated with impairment of T-lymphocyte proliferation and increased incidence of severe infectious complications.
Subjects
膽道閉鎖
體液免疫功能
細胞免疫功能
biliary atresia
humoral immunity
cellular immunity
Type
text
File(s)![Thumbnail Image]()
Loading...
Name
ntu-95-P93421001-1.pdf
Size
23.31 KB
Format
Adobe PDF
Checksum
(MD5):ce86587e458dffdd08ed6bbe10cbbd06