T-lymphocyte subsets in predicting the response to drug therapy of typhoid fever in children

Abstract EN

Background : typhoid fever, a food-borne disease caused by salmonella species, is a worldwide prevalent disease.

In endemic areas, children are at highest risk owing to weaning from passively acquired maternal antibody and lack of acquired immunity.

Several studies have been done to clarify the pathogenesis and underlying immune aspects of typhoid fever.

Study T-lymphocyte subsets (CD4, CDa and CD4 / CD8), as well as, their value in predicting the clinical course of children suffering typhoid fever.

Methods : Thirty consecutive children, who were admitted to Zagazig Fever Hospital with proven diagnosis of typhoid fever, were included in the study.

They were 20 males and 10 females, of ages ranging from 3 to 13 years.

In addition, 10 age-and sex-matched healthy children served as a control group.

A verbal consent was obtained from parent(s) of each child before inclusion to the study.

All children were subjected to history-taking, physical examination, and routine investigations (CBC, ESR, CRP, Widal and stool culture), as well as immunophenotyping of lymphocytes as CD /, CDS/ and CD47CDg*.

Results : Twenty patients (66.7%) were responsive to therapy and 10 patients (33.3%) were resistant.

Toxic look, constipation, high fever, splenomegaly and increased CRP were significantly presented in patients who displayed resistance to drug therapy.

Both CD4* and CD8* T-lymphocytes were significantly increased in patients than in control children, and in resistant cases than in responsive cases (before treatment).

On the other hand, CD47CD8* showed no significant changes.

The majority of children with typhoid fever are resistant to treatment with chloramphenicol and co-traimoxazole.

Out of-T-lymphocyte subsets, CD4+ showed significant correlations with S.

tophi H agglutination titer and ESR, with no significant correlation with other parameters studied.

Conclusion : blood levels of T-! Lymphocyte subsets can be used as markers for effectiveness of therapy.

Further studies of immune modulating therapy are : required to evaluate its effectiveness especially in resistant typhoid patients.