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Ultrastructural Changes of Blood Cells in Children with Generalized Purulent Peritonitis: A Cross-Sectional and
Ulyana Halyuk1, Olena Lychkovska2, Oksana Mota1
1Department of Normal Anatomy, Lviv National Medical University, UA-79010 Lviv, Ukraine.
Insights
Pediatric abdominal septic shock causes significant blood cell ultrastructural changes, impacting gas exchange and organ function. These alterations in erythrocytes, granulocytes, and lymphocytes reveal cellular stress and decompensation during severe illness.
Area of Science:
- Pediatric critical care medicine
- Hematology
- Cellular biology
Background:
- Abdominal sepsis and septic shock in children lead to severe systemic complications.
- Understanding blood cell ultrastructural changes is crucial for managing pediatric septic shock.
Purpose of the Study:
- To investigate the ultrastructural changes in blood cells of children with abdominal septic shock due to generalized appendicular peritonitis.
- To correlate these cellular changes with the severity of shock and organ dysfunction.
Main Methods:
- Cross-sectional prospective study of 15 children (aged 6-12) with generalized appendicular purulent peritonitis and septic shock (Stage I-II).
- Analysis of blood cell ultrastructure using electron microscopy.
- Assessment of clinical parameters related to shock stage and organ function.
Main Results:
- Erythrocyte ultrastructural changes did not align with eryptosis, suggesting damage from intoxication and metabolic disturbances.
- Granulocyte hyperactivation was observed, leading to resource depletion and ineffective bacterial killing.
- Lymphocytes showed significant disruptions in nuclear and intracellular membranes, chromatin distribution, and organelle development, indicating metabolic and energy supply decompensation.
Conclusions:
- Abdominal septic shock in children induces profound, distinct ultrastructural changes in erythrocytes, granulocytes, and lymphocytes.
- These cellular alterations contribute to impaired gas exchange, altered reactivity, and multi-organ dysfunction.
- The findings highlight the critical role of cellular pathology in pediatric abdominal sepsis and shock.
Abstract:
In conditions of abdominal sepsis with indications of first- or second-stage shock, blood cells undergo significant ultrastructural changes that cause impaired gas exchange, changes in reactivity, and decompensation of organs and systems functions. This paper presents a cross-sectional prospective study aimed at researching the ultrastructure of blood cells in children experiencing abdominal septic shock against the background of generalized purulent peritonitis of appendicular origin. This study was conducted with 15 children aged 6-12 who were undergoing treatment for generalized appendicular purulent peritonitis, with first- or second-stage abdominal septic shock, in emergency care. The changes in the ultrastructure of erythrocytes did not correspond to changes characteristic of eryptosis, which confirms their occurrence under the influence of such pathogenic factors as intoxication, metabolic, water-electrolyte balance, and acid-base disorders. Ultrastructural changes of granulocytes indicate their hyperactivation, which leads to the exhaustion of membrane synthetic resources, membrane destruction, ineffective expenditure of bactericidal factors on substrates that are not subject to destruction. In lymphocytes, disorganization of the nuclear membrane and intracellular membranes, uneven distribution of chromatin, the hypertrophied Golgi apparatus, and a large number of young mitochondria, lysosomes, ribosomes, vesicles manifesting the disruption of metabolism, stress and decompensation of energy supply and protein synthesis systems, have been demonstrated. In conditions of abdominal sepsis with indications of first- or second-stage shock, blood cells undergo substantial ultrastructural changes causing gas exchange disruption, changes in reactivity, as well as decompensation of organs and system functioning.
