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|Title||Immunological Assessment of β-thalassemic Major Children Aged 5-12 Years Old Attending Abd El-Aziz El-Rantisy Hospital in Gaza strip|
Background: Beta-thalassemia major patients suffer from many problems rather than severe anemia. Immune abnormalities have been suggested as a precipitating factor for the fourth most common cause of death in β-thalassemia. These abnormalities have been attributed both to the disease itself and to the applied therapeutic intervention. Objective: to assess some immunological parameters in children aged 5-12 years old with β-Thalassemia major inGaza Strip. Materials and methods: this case-control study comprised 43 β-thalassemic major children aged 5-12 years old attending Abd El-Aziz El-Rantisy hospital and 43 healthy children served as controls. Cases and controls were matched for age and sex. Blood samples were collected by a well-trained nurse from thalassemic children just before a scheduled transfusion of packed red blood cells and also from controls. Complete blood count (CBC) was done in the same day of collection. Serum levels of interleukin-1-β (IL-1-β), interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) cytokines, immunoglobulins IgG, IgA and IgM, complements C3,C4, ferritin and C-reactive protein(CRP) were determined. Results: the average age of the study population was 7.9±2.2 years. Most patients 29 (67.4%) had allergic reactions. Discharge of desferrioxamine was intramuscular in 25 (58.1%) patients and subcutaneous in 17 (39.5%) patients, one patient (2.3%) refused iron chelation therapy. In general primary and secondary blood indices were significantly decreased in thalassemic children compared to controls. The total white blood cell (WBCs) and lymphocytes (LYMP) were significantly increased in patients compared to controls (8.9±2.1 V.s 7.9±2.0 X103cell/μl, p=0.025 and 3.6±0.9 V.s 3.1±0.79 X103cell/μl, p=0.003, respectively). WBCs and LYMP significantly decreased with allergic reactions (8.5±2.2 V.s 9.9±1.6 X103cell/μl, p=0.042 and 3.4±0.9 V.s 4.0±0.9 X103cell/μl, p=0.050, respectively). Ferritin level in patients was markedly higher than in controls (3138.0±1041.5 V.s 17.3±2.5 ng/ml, p=0.000). Ferritin level showed positive association with age and allergic reaction. Complements 3 and 4 reduced significantly in thalessemic children (118.7±12.4 V.s 136.6 ±23.3 mg/dL, p=0.000 and 49.3±13.4 V.s 62.3±21.6 mg/dL, p=0.001, respectively), regardless of allergic reaction, age, ferritin level and CRP. IgM and IgA were within the normal levels compared to control. However lower level of IgG was found in patients. Higher levels of IgG, IgM and IgA were found with increasing age and in positive CRP patients (p<0.05). On the other hand, immunoglobulins neither had a relation with ferritin nor with allergic reactions. Cytokines were normal that they almost showed undetected levels in controls and patients (TNF-α: 56.1 and 97.7%, IL-6: 95% and 88.4%, and IL-I-β: 100% for both controls and patients). C-reactive protein status didn’t differ significantly between controls and cases.
|Publisher||the islamic university|
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