title: Impaired T-lymphocyte proliferation function in biliary atresia patients with chronic cholestatic jaundice after a Kasai operation.
abstract: To investigate the association between chronic cholestatic jaundice, systemic immunity, and various infectious complications in patients with biliary atresia (BA), we performed a survey of the systemic immune function in 30 children with BA. Patients were divided into a jaundice group (total serum bilirubin > or = 2 mg/dL for >6 mo) and control group (total serum bilirubin <2 mg/dL for >6 mo) with comparable age. Patients were tested for serum immunoglobulin and complement levels, mitogen response, interleukin (IL)-4, IL-5, and interferon-gamma production after phytohemagglutinin (PHA) stimulation, blood cell and lymphocyte subpopulation counts, phagocytic function, and leukocyte adhesion complex. They were then followed prospectively for 6 mo, and severe infectious complications requiring hospitalization were recorded. Compared with jaundice-free patients, T-lymphocyte proliferation function, determined by PHA mitogen test was significantly lower (p = 0.02) in BA patients with chronic cholestatic jaundice after a Kasai operation. During the study period, patients with chronic cholestatic jaundice had a higher risk of severe infectious complications than their jaundice-free counterparts (risk ratio = 5.87; p = 0.001). In conclusion, BA patients with chronic cholestatic jaundice are associated with impairment of T-lymphocyte proliferation and increased incidence of severe infectious complications.
authors.affiliation: Department of Pediatrics, National Taiwan University Hospital, National Taiwan University, Taipei, Taiwan.
authors.forename: Jia-Feng
authors.initials: JF
authors.lastname: Wu
authors.forename: Bor-Luen
authors.initials: BL
authors.lastname: Chiang
authors.forename: Huey-Ling
authors.initials: HL
authors.lastname: Chen
authors.forename: Hong-Shee
authors.initials: HS
authors.lastname: Lai
authors.forename: Mei-Hwei
authors.initials: MH
authors.lastname: Chang
authors.forename: Yen-Hsuan
authors.initials: YH
authors.lastname: Ni
mesh_terms: D000293:Adolescent; D000328:Adult; D001656:Biliary Atresia / Q000150:complications / Q000276:immunology* / Q000601:surgery*; D001662:Biliary Tract Surgical Procedures; D049109:Cell Proliferation; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007109:Immunity / Q000502:physiology; D007223:Infant; D041781:Jaundice, Obstructive / Q000209:etiology / Q000276:immunology* / Q000601:surgery*; D008297:Male; D011183:Postoperative Complications; D013601:T-Lymphocytes / Q000502:physiology*