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[Monitoring of the inflammation in children before and after tonsillectomy]
I Steiner1, M Sobieska, M Grzegorowski
1Klinika Otolaryngologii Dzieciecej Instytutu Pediatrii Akademii Medycznej im. Karola Marcinkowskiego w Poznaniu.
Insights
Acute phase proteins and immunoglobulin levels in children undergoing tonsillectomy may indicate chronic inflammation, even without elevated antistreptolysin titer, suggesting potential streptococcal infections. This aids in assessing the need for antibiotic therapy.
Area of Science:
- Laryngology
- Immunology
- Biochemistry
Context:
- Tonsillectomy is a common procedure for pediatric laryngological indications.
- Assessing chronic inflammation in children requires reliable biomarkers.
- Existing diagnostic markers may not fully capture the inflammatory picture.
Purpose:
- To investigate acute phase proteins and immunoglobulin profiles in children undergoing tonsillectomy.
- To explore the microheterogeneity of alpha1-acid glycoprotein (AGP) and alpha1-antichymotrypsin (ACT) in relation to inflammation.
- To determine if these markers can aid in controversial tonsillectomy indications.
Summary:
- Measurements of C-reactive protein (CRP), AGP, ACT, IgA, IgG, IgM, and antistreptolysin titer were performed in 54 children.
- Microheterogeneity of AGP and ACT was analyzed using crossed affinity immunoelectrophoresis.
- No significant differences were found in parameters based on antistreptolysin titer, suggesting non-streptolysin O producing streptococci may cause inflammation.
Impact:
- The findings suggest that acute phase proteins and glycosylation profiles can serve as additional markers in laryngology.
- Absence of arthritic pain does not rule out the need for antibiotic therapy post-tonsillectomy.
- These markers may help in cases with controversial indications for tonsillectomy.
Abstract:
A group of 54 children aged from three to 13 years was qualified to tonsillectomy for laryngological indications. In sera of all children following measurements were performed: the concentrations of C-reactive protein (CRP), alpha1-acid glycoprotein (AGP) and alpha1-antichymotrypsin (ACT) were measured using rocket immunoelectrophoresis according to Laurell, also concentrations of three main immunoglobulin classes (IgA, IgG, IgM) and antistreptolysin titer. The microheterogeneity of both AGP and ACT was investigated, using crossed affinity immunoelectrophoresis according to Bog-Hansen with Concanavalin A (Con A) as a ligand. Results were expressed as reactivity coefficients (RC), being the proportion of all Con A-reacting variants to the non-reacting variant. It is worth mentioning that there was no difference in all investigated parameters as well between groups obtained by categorizing children according to the presence or absence of elevated antistreptolysin titer. It may mean that at least in some cases the chronic inflammation was caused by streptococci non-producing streptolysin O. The results obtained suggest that the absence of the arthritic pain does not exclude the need of antibiotic therapy in children after tonsillectomy. Generally it is postulated that estimation of acute phase proteins concentrations and glycosylation profiles, which were previously shown to be useful in clinical assessment of various diseases may serve as additional marker in laryngology in cases where indications to tonsillectomy are still controversial.