Immunological spectrum of childhood tuberculosis

Fifty-three children with tuberculous meningitis (TBM) were studied in parallel with 37 children with primary pulmonary complex (PPC), 32 tuberculin skin positive controls, and 38 skin negative controls for immunological evaluation. Proportions of peripheral blood total T and T helper lymphocytes (TH) were significantly reduced in TBM (T55, TH32) as compared to PPC (T70, TH40) and Controls (T74, TH43), but response to mitogens phytohaemagglutinin (PHA) and poke weed mitogen (Pwm) were comparable in all the groups. Response of peripheral blood lymphocytes to tubercular protein (PPD) was significantly greater in the tuberculin skin positive group, but comparable between the TBM and PPC groups. There was no significant difference in the proportion of B lymphocytes, antibody levels to PPD and monocyte capacity to release hydrogen peroxide in the four groups. These findings suggest that there is no definite immunological spectrum in childhood tuberculosis.