Humoral immunity vs oropharyngeal flora alterations in children prior to and after adenotonsillectomy

ABSTRACT

Levels of serum immunoglobulins [IgG, IgA and IgM] were determined in 30 patients with chronic adenotonsillitis by the single radial immunodiffusion technique, prior to and one month after adenotonsillectomy. Twelve normal individuals were included as a control group. Swabs of the posterior oropharyngeal wall, before and a month after the operation, were fully identified bacteriologically by the use of the VITEK systems. The organisms obtained preoperatively were of resident as well as pathogenic flora. One month after adenotonsillectomy, there was a marked drop in the number of patients from whom Streptococcus pyogenes were recovered with the return of the incidence of Streptococcus viridans near the normal level. Streptococcus pneumonia, Staphylococcus aureus and Diphtheroid bacilli, on the other hand, showed no marked change. A significant preoperative high level of serum IgG and IgA was recorded, which postoperatively significantly decreased to near its level in the control group. The postoperative level of IgM showed slight drop, but neither significantly differ from the normal nor from the preoperative level. Thus, preoperative estimation of serum immunoglobulins or simply IgA level as well as a swab from the posterior oropharyngeal wall may be of diagnostic as well as of prognostic value