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Reference ranges for lymphocyte subsets in pediatric patients

P K Kotylo1, N S Fineberg, K S Freeman

  • 1Department of Pathology/Hematopathology Division, Indiana University School of Medicine, Indianapolis.

American Journal of Clinical Pathology
|August 1, 1993
PubMed
Summary
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Pediatric lymphocyte subset reference ranges change significantly by age 3. After this age, most ranges approximate adult values, but age-adjusted ranges are crucial for young children.

Area of Science:

  • Immunology
  • Pediatric Hematology
  • Clinical Laboratory Science

Background:

  • Establishing accurate reference ranges for lymphocyte subsets is crucial for diagnosing pediatric immune disorders.
  • Existing reference ranges may not adequately capture age-specific variations in lymphocyte populations during childhood.

Purpose of the Study:

  • To determine age-specific reference ranges for peripheral blood lymphocyte subsets in healthy children.
  • To identify the age at which pediatric lymphocyte subset values approximate adult reference ranges.

Main Methods:

  • Analysis of peripheral blood samples from 130 healthy pediatric patients (1 month to 17 years).
  • Immunophenotyping using monoclonal antibodies and whole blood lysis technique.
  • Flow cytometry analysis to quantify lymphocyte subsets (CD2, CD3, CD4, CD8, CD19) and CD4/CD8 ratios.

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Main Results:

  • Statistically significant changes in most lymphocyte subsets were observed around age 3 years.
  • Relative and absolute counts of total lymphocytes, CD2, CD4, CD19, and CD4/CD8 ratios were highest at birth, decreasing by age 3.
  • Relative CD8 counts were low in early childhood, increasing to adult levels after age 3; CD3 relative percentage remained stable.

Conclusions:

  • Pediatric lymphocyte subset reference ranges exhibit significant age-dependent variations, particularly before age 3.
  • Age-adjusted reference ranges are necessary for accurate interpretation of lymphocyte subset data in young children.
  • Adult reference ranges may be applicable for children over 3 years, but caution is advised for younger age groups.