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Anergy in pediatric head trauma patients
N W Wilson1, A Gooding, B Peterson
1Department of Pediatrics, University of California-San Diego, La Jolla 92093.
American Journal of Diseases of Children (1960)
|March 1, 1991
Summary
Children with severe trauma who show no delayed-type hypersensitivity (anergic) are more prone to infection. This immune test can identify children at higher risk for nosocomial infections after injury.
Area of Science:
- Pediatric critical care medicine
- Immunology
- Trauma surgery
Background:
- Severe blunt trauma in children can impair cellular immune function.
- Assessing immune status is crucial for predicting infection risk in pediatric trauma patients.
Purpose of the Study:
- To evaluate cellular immune function in children post-severe blunt trauma.
- To determine if delayed-type hypersensitivity skin testing can predict infection risk.
Main Methods:
- Utilized the CMI Multitest system to assess delayed-type hypersensitivity in 25 pediatric trauma patients.
- Monitored patients for infection over 3 weeks.
- Measured circulating lymphocyte subpopulations (T101, CD4, CD8, B cells) in a subset of patients.
Main Results:
- 56% of children were anergic (no skin test reaction).
- Anergic children had a significantly higher infection rate (79%) compared to non-anergic children (27%).
- Absolute B cell counts decreased significantly by day 7 post-injury, while T-cell populations remained stable.
Conclusions:
- Anergy in pediatric trauma patients is associated with increased susceptibility to infection.
- Delayed-type hypersensitivity skin testing is a valuable tool for identifying children at high risk for nosocomial infections.
- Pediatric trauma impacts B cell numbers but not T cell populations, differing from adult responses.