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Defective neutrophil motility in children with chronic liver disease
Insights
Children with chronic liver disease often have neutrophil defects, increasing infection risk. Byler
Area of Science:
- Pediatric Gastroenterology and Hepatology
- Immunology
- Infectious Diseases
Background:
- Children with chronic liver disease may have increased susceptibility to bacterial infections.
- Neutrophil function, specifically chemotaxis, plays a crucial role in host defense against pathogens.
Purpose of the Study:
- To assess neutrophil motility in children with various chronic liver diseases.
- To estimate the risk of bacterial infections associated with neutrophil defects in these patients.
Main Methods:
- Neutrophil motility was evaluated in 31 children diagnosed with chronic liver disease.
- Patients included those with chronic hepatitis (persistent and active) and cholestasis (intrahepatic and extrahepatic).
- Correlation between neutrophil chemotaxis defects and occurrence of serious bacterial infections was analyzed.
Main Results:
- Twenty out of 31 children exhibited a persistent defect in neutrophil chemotaxis.
- Hepatitis B virus-related chronic hepatitis and idiopathic intrahepatic cholestasis showed neutrophil defects without significant infection predisposition.
- Byler's disease and biliary atresia were associated with neutrophil defects and a higher frequency of severe bacterial infections.
Conclusions:
- Persistent neutrophil chemotaxis defects are common in children with chronic liver disease.
- The clinical significance of these defects varies by liver disease type, with Byler's disease and biliary atresia posing higher infection risks.
- Targeted monitoring and management of infections may be warranted in children with specific chronic liver conditions and neutrophil dysfunction.
Abstract:
Neutrophil motility was assessed in 31 children with chronic liver disease to estimate the eventual increased susceptibility of these patients to bacterial infections. Twelve children had chronic hepatitis (seven with chronic persistent hepatitis and five with chronic active hepatitis), which was mostly related to hepatitis B virus (HBV) infection. Nineteen children had chronic intrahepatic or extrahepatic cholestasis. A total of six serious bacterial infections occurred in four of the 31 patients during the study. Twenty of the 31 children had a persistent defect of neutrophil chemotaxis. This defect was found in four types of childhood chronic liver disease: HBV-related chronic hepatitis and idiopathic intrahepatic cholestasis of infancy, in which the defect did not seem to predispose significantly to bacterial infection, and in Byler's disease and biliary atresia, in which this neutrophil defect was associated with an increased frequency of severe infections.