Related Experiment Video
Updated: Dec 16, 2025
Assessment of Intestinal Transcytosis of Neonatal Escherichia coli Bacteremia Isolates
Published on: February 17, 2023
Immune function and infectious complications in children with jejunoileal atresia
Sittichoke Prachuapthunyachart1, Shaheed Merani2, Madeline Cloonan2
1Pediatric Gastroenterology, Hepatology and Nutrition, University of Nebraska Medical Center and Children's Hospital & Medical Center, Omaha, NE, United States.
Insights
Children with isolated intestinal atresia (IA) may experience immunodeficiency and infections. Early immune screening in IA and multiple intestinal atresia (MIA) patients can improve outcomes.
Area of Science:
- Pediatric Surgery
- Immunology
- Gastroenterology
Background:
- Immune function differences between isolated intestinal atresia (IA) and multiple intestinal atresia (MIA) in children are not well understood.
- Such differences may impact infectious complications and patient outcomes.
Purpose of the Study:
- To investigate and compare immune function in children with IA and MIA.
- To determine the impact of immune function on infectious complications and patient outcomes in these pediatric populations.
Main Methods:
- A retrospective cohort study of children (0-19 years) with intestinal atresia from 2000-2016.
- Data collected included patient characteristics, surgical history, immunologic work-up, and infection-related hospitalizations.
- Comparison between IA and MIA groups using appropriate statistical tests (chi-square, Fisher's exact, Mann-Whitney).
Main Results:
- Over half of patients in both IA and MIA groups exhibited low CD counts for age.
- Hypogammaglobulinemia was observed in 6/12 IA and 3/8 MIA children.
- Frequent bacteremia occurred in 3/10 IA and 3/5 MIA children; MIA patients had worse post-transplant outcomes.
Conclusions:
- Children with IA may present with immunodeficiency and associated infectious complications.
- Immunologic evaluation is recommended for both IA and MIA children in intestinal rehabilitation programs.
- Early screening for immunodeficiency can guide interventions and improve patient outcomes.
Objective:
Little is known about differences in immune function among children with multiple intestinal atresia (MIA) and those with isolated intestinal atresia (IA), and how such differences may manifest as infectious complications and patient outcomes. This study aimed to investigate the immune function and its impact on patient outcomes in IA and MIA children.
Methods:
A single-center retrospective cohort study included children aged 0-19 years with intestinal atresia who were referred to a multidisciplinary intestinal rehabilitation program from 1/2000 to 12/2016. Data were collected for patient characteristics, surgical history, immunologic work-up, and infection-related hospitalizations. Groups of IA and MIA children were compared using chi-square test or Fisher's exact test for categorical variables and using Mann-Whitney test for continuous variables, as appropriate.
Results:
Twenty-seven children (18 IA, 9 MIA) were included. More than half of the patients had low CD counts for age in IA and MIA groups: CD3 58.3% vs. 66.7% (p = 1.0), CD4 50.0% vs. 66.7% (p = 0.7), CD8 67.7% vs. 88.9% (p = 0.3), respectively. Six out of 12 IA children and 3 out of 8 MIA children had hypogammaglobulinemia (p = 0.7). Three out of 10 IA patients and 3 out of 5 MIA children had frequent bacteremia (≥5/year). Eight children (6 IA and 2 MIA) underwent intestinal and/or liver transplant; MIA children had a worse posttransplant outcome.
Conclusions:
IA children may have an immunodeficiency and associated infectious complications requiring hospitalization. We suggest performing immunologic evaluation not only in MIA but also in IA children presenting to an intestinal rehabilitation program to identify immunodeficiency. Early immunodeficiency screening may help initiate appropriate intervention and improve patient outcomes.
Level Of Evidence:
Level III.
Related Concept Videos
01:25Immunodeficiency Diseases
There are three main causes of immunodeficiency...
01:26Factors Affecting the Risk of Infection
The integrity and count of the white blood cells help the body resist pathogens and fight infection. When impaired, it reduces the body's resistance to pathogens. The acidic pH levels of the gastrointestinal, genitourinary tracts, and skin...
01:21Inflammatory Bowel Disease V: Surgical Management
Here are some common surgical interventions for IBD:
01:22Development of Immunocompetence
The initial cells that migrate from the fetal thymus settle within the skin and epithelial tissues lining the mouth, digestive tract, and in females, the uterus and vagina. These cells, including skin-based dendritic cells, serve as antigen-presenting cells, playing a key role in T cell activation.
Subsequent T...
01:27Inflammatory Bowel Disease I: Ulcerative Colitis
Inflammatory bowel disease, or IBD, encompasses a group of disorders characterized by chronic inflammation or ulceration of the gastrointestinal tract.
Risk Factors
The exact cause of IBD remains unclear, although it is believed to be due to a mix of genetic, environmental, microbial, and immune factors. Genetic factors are significant in determining susceptibility to IBD, with family history being a critical risk factor. Individuals with a first-degree relative who has IBD are at...
01:30Inflammatory Bowel Disease II: Crohn's Disease
Inflammatory bowel disease, commonly known as IBD, refers to a collection of disorders that lead to persistent inflammation of the gastrointestinal tract. The two types of IBD are ulcerative colitis, which impacts the colon, and Crohn's disease, which can involve any part of the gastrointestinal segment.
Crohn's disease
Crohn's disease is a chronic, systemic inflammatory bowel disease (IBD) that predominantly affects the gastrointestinal tract. It is marked by...