ABSTRACT
Se realiza una investigación prospectiva con el objetivo de determinar si la hiperferritinemia es un factor pronóstico de inmunosupresión en pacientes con síndrome de inmunodeficiencia adquirida (SIDA). La población estuvo conformada por 40 pacientes hospitalizados en el Hospital Universitario de Maracaibo, durante los meses de Enero a Octubre del 2010. 27 (67,50%) pacientes fueron de sexo masculino y 13 (32,50%) femeninos. El 55,00% presentó hiperferritinemia. 22,50% presentaron contaje de linfocitos T CD4+ entre 200-400 cel/mm³ con un promedio de ferritina de 144,2 ± 127,1 ng/mL y, el 77,50% contaje de linfocitos T CD4+ < 200 cel/mm³ con un promedio de ferritina de 1100,0 ± 984,7 ng/mL (p = 0,01). Se demostró una correlación inversamente negativa entre niveles elevados de ferritina con niveles bajos de contaje de linfocitos T CD4+ (r = 0,3135, p = 0,030), cifras bajas de leucocitos (r= 0, 7458, p= 0,012), cifras bajas de proteínas (r= 0,5814, p= 0,01) y una relación directamente proporcional con el aumento de la VSG (r = 0,7422, p= 0,001). En los pacientes fallecidos el promedio de ferritina (1180,0 ± 1.072) estadísticamente (p= 0,018) fue más elevado en comparación con el promedio de ferritina (474 ±440,2) de los pacientes que sobrevivieron. Se concluye que se puede tomar en cuenta a la hiperferritinemia como factor pronóstico de inmunosupresión en pacientes con diagnóstico de SIDA
A prospective study was carried out to determine if hyperferritinemia is a predictive factor for immunosuppression in patients with acquired immunodeficiency syndrome (AIDS). The population consisted of 40 patients hospitalized at the University Hospital of Maracaibo (Hospital Universitario de Maracaibo), from January to October, 2010. Twenty-seven (67.50%) patients were male and 13 (32.50%) were female. 22.50% had a T CD4+ lymphocyte count between 200-400 cells/mm³ with a mean ferritin of 144.2 ± 127.1 ng/mL; 77.50% had a T CD4+ lymphocyte count of <200 cells/mm³ and a ferritin average of 1100.0 ± 984.7 ng/mL (p = 0.01). An inverse negative correlation was found between high ferritin levels and low T CD4+ lymphocyte count (r = 0.3135, p = 0.030), low numbers of leukocytes (r = 0, 7458 p = 0.012), low levels of protein (r = 0.5814, p = 0.01), and a directly proportional relation with the increase of ESR (r = 0.7422, p = 0.001). In patients who died, the mean ferritin level (1180.0 ± 1,072) statistically (p = 0.018) was higher compared with the average ferritin level (474 ± 440.2) of patients who survived. Conclusions are that these results are sufficiently relevant to take hyperferritinemia into account as a prognostic factor for the immunosuppression of diagnosed AIDS patients
Subject(s)
Humans , Male , Adult , Female , Phenylketonurias/immunology , Phenylketonurias/metabolism , Immunosuppression Therapy/methods , Prognosis , Acquired Immunodeficiency Syndrome/metabolismABSTRACT
BACKGROUND: An increased susceptibility to infections has been observed in some patients with phenylketonuria (PKU), which is not well known whether it is due to alterations of plasma essential amino acid concentrations or to some other factors. OBJECTIVE: This study is designed to establish B cell and T cell functions in 44 children with classical PKU and tetrahydrobiopterin (BH4) deficiencies and the effects of too high plasma phenylalanine (PA) concentrations (16.53 to 30.54 mg/dL) on the same parameters. DESIGN: B and T cell functions of 33 children with classical PKU (divided into two groups based on fasting mean plasma PA concentrations: Group-I = 20.9 +/- 3.7 mg/dL, Group-II = 3.8 +/- 1.02 mg/dL), and 11 children with BH4 deficiencies (Group III) were studied. The results were compared between the groups and referenced with previously reported values from healthy controls. RESULT: Delayed type skin hypersensitivity responses to purified protein derivative (PPD) in Group I and phytohaemagglutinin (PHA) in Group I, III were lower than the other groups and healthy controls. Plasma IgG and IgM concentrations of Group I was lower than the reference values. Although mean serum zinc and iron levels of all patients were lower than published values of healthy children, zinc and iron deficiencies in Group I, III were much more prominent as compared to Group II. CONCLUSION: The somewhat low plasma IgG concentrations in Group I may be related to the very high plasma PA levels, however the role of zinc deficiency as a causal factor can not be ruled out. BH4 metabolism defects do not appear to affect the same parameters. Impaired delayed skin hypersensitivity responses in Group I and III can be explained by severe serum zinc deficiency. In the light of this study, we conclude that in order to establish a causal relationship between PKU and immune functions, further studies need to be conducted after the correction of micro-nutrient status of such children.