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[Immunological study on chyluria]
Insights
Chyluria patients exhibit suppressed cellular immunity, indicated by reduced lymphocytes and impaired T-cell function. While immunoglobulin levels remain normal, this immune suppression may increase risks for opportunistic infections and tumors.
Area of Science:
- Immunology
- Urology
Context:
- Chyluria, a condition characterized by lymphatic fluid in urine, affects immune function.
- Understanding the immunological profile of chyluria patients is crucial for managing potential complications.
Purpose:
- To investigate the immunological status, specifically cellular immunity, in patients diagnosed with chyluria.
- To assess T-cell and B-cell percentages, lymphocyte blastogenesis, and skin test reactivity in chyluria patients.
Summary:
- Immunological studies in 87 chyluria patients revealed significantly lower lymphocyte counts and impaired lymphocyte blast formation.
- T-cell and B-cell percentages tended to decrease, and PPD skin test reactivity was reduced, indicating suppressed cellular immunity.
- Immunoglobulin levels (IgG, IgA, IgM) were within normal ranges, suggesting humoral immunity was unaffected.
Impact:
- Findings suggest that suppressed cellular immunity in chyluria patients may elevate the risk of opportunistic infections and malignant tumors.
- Monitoring immune status in chyluria patients is recommended for proactive management and prevention of serious sequelae.
Abstract:
Immunological studies were performed in 87 patients with chyluria referred to our clinic from January 1982 to December 1988. White blood cell count in 78 patients was 5210.3 +/- 1440.9/mm3. The fraction and the number of lymphocyte were 18.7 +/- 9.5% and 934.1 +/- 521.6/mm3, respectively: they were lower than normal limit. The percentages of T and B lymphocytes studied in 46 patients were 79.3% +/- 11.2% (normal range: 76-86) and 10.4 +/- 7.9% (normal range: 8-16), respectively: both lymphocytes tended to decrease in percentage. Lymphocyte blast formation stimulated with phytohemagglutinin (PHA) was carried out in 20 patients. The mean of the blast formation was 17410.0 +/- 10275.1 c.p.m. (normal range: 377700-62400), and much lower than normal value. Of 22 patients who had PPD skin test, only 9 (40.9%) were positive. These findings signified that cellular immunity was suppressed in patients with chyluria. On the other hand, the value of immunoglobulin was within normal range (IgG: 1325.3 +/- 475.6 mg/dl, IgA: 242.0 +/- 98.3 mg/dl, IgM 130.4 +/- 95.9 mg/dl). Study on the values of laboratory examinations showed statistically positive correlation between total lymphocyte population and T cell number, and between total lymphocyte population and lymphocyte blast formation. In patients with chyluria, serious sequelae have not been reported. However, care should be taken for possible opportunistic infection and, particularly, malignant tumors because suppression of cellular immunity may be one of the promoting factors of malignant tumors.