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Acute chylothorax in children: selective retention of memory T cells and natural killer cells

Jordan S Orange1, Raif S Geha, Francisco A Bonilla

  • 1Division of Immunology, Children's Hospital, Enders Building, 300 Longwood Avenue, Boston, MA 02115, USA.

The Journal of Pediatrics
|September 13, 2003
PubMed

Insights

Draining chylothorax causes significant IgG and lymphocyte loss, but immune function remains largely intact. Intravenous immunoglobulin (IVIG) did not prevent infections in this small study of hypogammaglobulinemia patients.

Area of Science:

  • Immunology
  • Pulmonology

Background:

  • Hypogammaglobulinemia is a condition characterized by low levels of immunoglobulins.
  • Acute chylothorax involves the accumulation of chylous fluid in the pleural space.

Purpose of the Study:

  • To evaluate immunodeficiency in patients with hypogammaglobulinemia and draining acute chylothorax.
  • To assess humoral and cellular immunity in this patient population.

Main Methods:

  • Retrospective review of 8 patients with chylothorax.
  • Evaluation of humoral and cellular immunity.
  • Analysis of chylous fluid for cellular losses.

Main Results:

  • Patients exhibited hypogammaglobulinemia and lymphopenia.
  • T cells were decreased, while natural killer cells were increased in peripheral blood.
  • In vitro immune responses and vaccine-specific immunity were preserved.

Conclusions:

  • Chylothorax leads to IgG and lymphocyte depletion but preserves memory T cells and NK cells.
  • Specific antibody levels and T cell function were maintained.
  • Intravenous immunoglobulin (IVIG) did not demonstrate clear protection against infections in this cohort.
Abstract

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