Immune status with empyema thoracis.

OBJECTIVE: To evaluate the humoral and cell mediated immune status of children with empyema thoracis. METHODS: Serum IgG, IgA, IgM, Complement C3 assay and cell mediated immunity (CMI) tests were performed in 33 patients of empyema thoracis, and 14 healthy age matched controls. RESULTS: The mean serum IgG and IgA levels in empyema thoracis and its subgroups were significantly raised as compared to controls. The overall values of IgG and IgA were 104% (p<0.001) and 114% (p<0.01) of normal mean, respectively. The mean serum IgM and complement C3 levels did not differ significantly in both the groups. The frequency of negative skin reaction to purified protein derivative (PPD) was significantly higher in children with empyema thoracis as compared to controls (p<0.05). The mean absolute lymphocyte count (ALC) was significantly decreased and serum adenosine deaminase (ADA) activity was significantly raised in empyema thoracis in comparison to controls. The overall ALC was 76.1% (p<0.01) and serum ADA activity was 169.4% (p<0.001) of normal mean, respectively. No significant differences were observed in the mean levels of immunoglobulins, complement C3 and CMI tests between pyothorax and pyopneumothorax and pleural fluid culture positive and negative cases. CONCLUSIONS: Thus, both humoral and cell mediated immunity were affected in empyema thoracis patients. However, CMI demonstrated more pronounced change in comparison to humoral immunity.