Significance of elevated aanticardiolipin antibodies in children with protal vein thrombosis

Portal vein thrombosis [PVT] is characterized by obscure obstruction of the portal vein somewhere along its course between the hilum of spleen and portahepatis though hypercoagulable states are implicated in the causation of PVT, the etiology remains unknown in most cases. Anticardioitpin antibodies [a CL] are autoantibodies, whose presence is a known cause of hypercoagulable state. In view of the strong association of aCL with thrombosis, we estimated the levels of aCL-JgG and 1gM in 25 children suffering from PVT with age ranged from 3.5 to 12.0 years with the mean +/- SD 6.9 +/- 2.7 to evaluate the role of aCL in the pathogenesis and causation of PVT. An indirect ELISA technique was used for the assay. Values exceeding the mean+2SD [cut-off value] of healthy controls were taken as abnormal. The study revealed that the levels of aCL, specially the IgG were significantly elevated [p<0.01] in patients with PVT in comparison to the control group [the mean values +/- SD were 12.94 +/- 6.56 versus 6.75 +/- 2.19 GPLU/ml] while there was a mild non-sigi4flcanr increase of aCL-IgM than the control [the mean values +/- SD were 1.60 +/- 2.25 versus 1.05 +/- 0.66 MPL U/ml] [p> 0.05]. Also the levels of aCL-lgG were above the cut-off value of the normal control in 13 patients [52%]. We found significant thrombocytopenia in children with PVT, the mean value +/- SD was 114.36 +/- 89.39 thousand/cmm, while that of the control was 240.1 +/- 45.47 thousand/cmm. In conclusion, aCL may have a role in the pathogenesis and causation of PVT, and it should be included in the investigation list of causes of PVT in children, as these patients may get benefit from the long-term use of anticoagulants

Effect of tonsillectomy on cellular immunity in children with recurrent attacks of acute follicular tonsilitis

To investigate the immunological function of the tonsils and the possible effects of their removal on the cellular immunity in children, we studied selected parameters of the cellular immune system, unprimed naive T-cell [CD[45] RA[+]], helper T-cell [CD[4]] and cytotoxic T-cell [CD[8]] of forty children with recurrent attacks of acute follicular tonsillitis aged 6-12 years [mean +/- SD 9.2 +/- 1.9 years] before and one week and two months after tonsillectomy, in comparison to ten age-matched healthy non tonsillectomized children [mean +/- SD 9.0 +/- 2.0 years]. CD[45] is a tyrosine phosphatase expressed on lymphocytes and acts as a positive regulator that is required for antigen stimulation and proliferation of T and B-cells. There was significant increase of CD[4] percentage and CD[45] RA+ percent before tonsillectomy when compared to the control group. While one week after tonsillectomy, the lymphocytes sub-populations CD[4] percentage and absolute count, CD[4] / CD[8] ratio and CD[45] RA+ were significantly decreased in comparison to the control group and returned back to normal levels after two months from the operation. During the post-operative follow up, we did not find any significant complaint suggesting sore throat or upper respiratory tract infection. These findings show that while tonsillectomy may lead to certain changes in the cellular immune system, these alterations are transient and clinically insignificant and no increased frequency of immunomodulated diseases should be expected