Serum Immunoglobulin Values and Lymphocytes' Phenotypes, in Children Undergoing Adneotonsillectomy

Abstract

Background: Chronic tonsillitis in childhood is a leading cause of adneotonsillectomy and there is a question for a long time, is there any risk of immune impairment after adneotonsillectomy? So we decided to evaluate immunologic parameter in children before and after adenoidectomy.

Methods: In this case control study, we enrolled 25 children (14 male) who were candidate for adneotonsillectomy in Rasoul Akram Hospital. We get adequate blood samples in three intervals (before surgery and two and six months after operation) from our patients to measure immunoglobulins IgA, IgM, IgG and IgG subclasses by nephelometric assay and to count lymphocyte subsets (markers CD2, Cd3, CD4, CD8, CD19, CD23 and CD56) by flow cytometry and ELISA methods.

Results: IgM, IgG and IgA had no significant changes postoperatively. IgG subclasses (IgG1, IgG2, IgG3 and IgG4) had small rises after operation. According to lymphocyte phenotypes, CD4+, CD23+ and CD56+ cells and CD4/CD8 ratio were constant through the three intervals. Mean CD8+ cells had significant decrease during these intervals (P value = 0.02) especially between specimens before and two months after operation (P value = 0.03). Serum value of CD19+ significantly decrease two (P = 0.00) and six months (P = 0.00) post tonsillectomy.

Conclusion: Adneotonsillectomy in the short time had no effect on immune system. Next studies must be design for long term evaluation of immune system of children with chronic tonsillitis.




doi: 10.4021/ijcp17e