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Prevalence of T-lymphocyte abnormalities in infants with congenital heart disease
Insights
Congenital heart disease in infants generally does not impair T-lymphocyte function. However, infants with high-risk cardiac lesions require immunologic evaluation for potential T-cell abnormalities.
Area of Science:
- Immunology
- Pediatric Cardiology
- Congenital Heart Disease
Background:
- Congenital heart disease (CHD) can impact immune function in infants.
- DiGeorge syndrome, a known cause of T-cell deficiency, is associated with specific cardiac anomalies.
Purpose of the Study:
- To investigate T-lymphocyte immunodeficiency in infants with congenital heart disease.
- To differentiate immune function based on cardiac lesion risk.
Main Methods:
- Prospective study of 32 infants (<6 months) with CHD.
- Categorization of cardiac lesions into high-risk and low-risk groups.
- Assessment of T-cell rosette (TCR) percentages and phytohemagglutinin (PHA) response.
Main Results:
- Overall T-lymphocyte function was normal in CHD infants.
- Infants with high-risk lesions showed a higher incidence of abnormal TCR and PHA responses.
- Three infants with DiGeorge syndrome exhibited T-cell abnormalities.
Conclusions:
- Newborn infants without DiGeorge syndrome typically have normal T-lymphocyte function.
- High-risk cardiac lesions warrant careful immunologic assessment to prevent complications.
Abstract:
Thirty-two infants younger than 6 months with catheterization-proved congenital heart disease were prospectively examined for T-lymphocyte immunodeficiency (compared with adult and normal newborn controls). Cardiac lesions were separated into two groups: (1) "high-risk" lesions previously associated with T-cell abnormalities in DiGeorge's syndrome, and (2) the remaining "low-risk" lesions. Cardiac patients as a whole did not have significant abnormalities in T-cell rosette (TCR) percentages (mean +/- SE, 50.0% +/- 22%) or response to phytohemagglutinin (PHA) (72,243 +/- 38,388 counts per minute). However, a greater percentage of patients with high-risk cardiac lesions had abnormal TCR and PHA results than either the control or low-risk group, due to the inclusion of three infants with DiGeorge's syndrome. These findings suggest that newborn infants without evidence of DiGeorge's syndrome have normal T-lymphocyte function. Infants with high-risk cardiac lesions deserve a careful immunologic evaluation to avoid significant morbidity and mortality.