Respiratory Viral Infections after Hematopoietic Stem Cell Transplantation in Children

This study was performed to characterize respiratory viral infections in pediatric patients undergoing hematopoietic stem cell transplantation (HSCT). Study samples included 402 respiratory specimens obtained from 358 clinical episodes that occurred in the 116 children of the 175 consecutive HSCT cohort at Seoul National University Children's Hospital, Korea from 2007 to 2010. Multiplex reverse-transcription polymerase chain reactions were performed for rhinovirus, respiratory syncytial virus (RSV), parainfluenza viruses (PIVs), adenovirus, human coronavirus (hCoV), influenza viruses and human metapneumovirus. Viruses were identified in 89 clinical episodes that occurred in 58 patients. Among the 89 clinical episodes, frequently detected viruses were rhinovirus in 25 (28.1%), RSV in 23 (25.8%), PIV-3 in 16 (18.0%), adenovirus in 12 (13.5%), and hCoV in 10 (11.2%). Lower respiratory tract infections were diagnosed in 34 (38.2%). Neutropenia was present in 24 (27.0%) episodes and lymphopenia was in 31 (34.8%) episodes. Sixty-three percent of the clinical episodes were hospital-acquired. Three patients died of respiratory failure caused by respiratory viral infections. Respiratory viral infections in pediatric patients who have undergone HSCT are common and are frequently acquired during hospitalization. Continuous monitoring is required to determine the role of respiratory viruses in immunocompromised children and the importance of preventive strategies.

Lymphopenia in severe acute respiratory syndrome: a summary on its frequency.

Severe acute respiratory syndrome (SARS) is a new human infectious disease caused by coronavirus. The first world outbreak occurs in 2002, starting from China and then thorough many countries. Abnormal hematological variables were common among patients with SARS. Concerning lymphocyte disorder, there were some previous studies reported the low lymphocyte in the patients with SARS. Here, the author performs a further analysis to document the frequency of the lymphopenia in SARS by the way of metanalysis study. Five available reports concerning the prevalence of lymphopenia in SARS among different populations were selected for further analysis in this study. Overall 637 SARS patients were retrospectively analyzed and 492 cases presented lymphopenia. According to this study, the overall prevalence rate of lymphopenia in SARS is 77.2 %. No significant correlation between the population ethnicity and the prevalence rate was detected in this study (P > 0.05). Here, the lymphopenia can be documented as an important characteristic of blood picture in the patients with SARS or it can indicate that "SARS is a viral-induced lymphopenia disease".

Linfopenia en pacientes hospitalizados / Lymphopenia among hospitalized patients

Se revisan retrospectivamente los recunetos linfocitarios y las asociaciones clínicas de 98 pacientes egresados del Servicio de Medicina del Hospital San Juan de Dios. En esta casuística se encuentra una alta frecuencia de lifopenia (62 por ciento ) y recuento linfocitario promedio de 887 linfocitos por mm3, siendo el valor de referencia de 1960 (p<0,001). La mayor incidencia de linfopenia se observó en pacientes mayores de 60 años, en tanto que las linfopenias más acentuadas se asociaron con patologías respiratorias y nefrourológicas. Los pacientes que recibieron terapias tradicionalmente asociadas a linfopenia, tales como corticoides, inmunosupresores y quimioterápicos, tuvieron cifras que aunque en rangos de linfopenia no fueron estadísticamente diferentes del conjunto de los pacientes que no recibieron dichas terapias (p>0,05)

Incidencia de citopenias en pacientes con infección por Virus de la Inmunodeficiencia Humana / Incidence of cytopenias in HIV-infected patient

Se estudia la incidencia de citopenias en 42 pacientes con infección por el Virus de Inmunodeficiencia Humana (HIV), según sus características clínicas y epidemiológicas. La trombocitopenia fue la característica hematológica de mayor incidencia en el estadio de infección asintomática. La asociación de trombocitopenia-linfopenia comenzó a instaurarse en el estadio de Linfadenopatía Generalizada Persistente (LGP). Hubo una incidencia progresiva de neutropenia y anemia desde el estadio de LGP al Síndrome de Inmunodeficiencia Adquirida (SIDA), el que se caracterizó, además, por marcada linfopenia y trombocitopenia. Sólo en el SIDA se observó pancitopenia. La incidencia similar de citopenias en los grupos estudiados sugiere que su presencia es independiente al grupo en riesgo a que pertenecen los individuos HIV-seropositivos.