Hepatosplenic mansonic schistosomiasis in children: lymphocyte subsets after splenectomy and autologous splenic transplatation

ABSTRACT

Eighteen children, eleven females and seven males, with hepatosplenic mansonic schistosomiasis, underwent splenectomy, ligature of the left gastric vein and autoimplantation of splenic tissue in the great omentum. Their blood lymphocyte subsets B; T; T helper (CD4); and T supressor (CD8) were analyzed. The patients were divided into two groups. 1 - represented by ten patients, six of whom had the lymphocyte subsets analysis performed before and three months after surgery. 2 - represented by eight patients who had undergone similar treatment with follow up greater than 12 months. The lymphocyte sbsets were recognized by monoclonal antibodies. Apart from B, all lymphocytes were in significant lower numbers before surgical treatment. At early follow up there was a significant increase in all lymphocyte subsets. There was a significant decrease of the ratio CD4/CD8 due to a greater increase in the expression of CD8. Lymphocyte counts from the second group were no different from the first group at early follow up. The isolated effect of autotransplantation of splenic tissue could not be demonstrated. These patients have had no increase in the rate of infections after surgery and none have developed overwhelming post-splenectomy septicemia.