Immunologic defects as possible causes of therapeutic failures in children with transposition of the great arteries
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Children with Transposition of the Great Arteries (TGA) often suffer severe infections due to impaired cellular immunity. These immune deficiencies, including low T-lymphocytes, correlate with poorer clinical outcomes and increased mortality in TGA patients.
Area of Science:
- Pediatric Cardiology
- Immunology
- Infectious Diseases
Background:
- Transposition of the Great Arteries (TGA) is a critical congenital heart defect.
- Children with TGA frequently experience recurrent and severe infections.
- Absence of thymic shadow on X-ray is noted in TGA patients.
Abstract:
Recurrent and severe infections and absence of thymic shadow in X-ray examination were observed in children with the transposition of the great arteries (TGA). Among 45 children (29 boys and 16 girls) with TGA whose age ranged from 3 days to 16 years and who were hospitalized during 1 year, infectious diarrhea was observed in 77.7% cases, urinary tract infections in 44.5%, respiratory tract infections in 42.2%, sepsis in 17.5%, and meningitis in 8.8%. Nine of the children died, sepsis was a cause of death in seven children, and there were postsurgical complications in two children. Immunologic abnormalities in children with TGA included a decreased level of T-lymphocytes and T29 degrees subpopulation, impaired mitogen-induced lymphoproliferation in vitro, and increased nitro blue tetrazolium (NBT) reduction activity of monocytes. Impaired parameters of cellular immunity correlated with worst clinical status. No disorders of humoral immunity were observed. These observations may be important for forming opinion about proper therapy and the cause of death in children with TGA.