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Frequency of immune alterations and micronutrient deficiency in severely malnourished children

Author: 
Flora Zárate-Mondragón, José Luis Arredondo-García, Silvestre García de la Puente, Silvestre Frenk-Freund, Francisco Espinosa-Rosales, Sara Espinosa-Padilla and Paola Sánchez-Soto
Subject Area: 
Health Sciences
Abstract: 

Objective. To determine the frequency of cellular and humoral immune alterations and micronutrient deficiencies in severely malnourished patients and the relationship between these conditions. Methods. Prospective, cross-sectional, analytical study of 30 severely malnourished 3-month-old to 5-year-old patients with measurements of vitamins B12, A, and E; folate; Zn, Cu, Se, and Fe; lymphocyte subpopulations; immunoglobulins; complement, lymphoproliferation; and 13 pneumococcal anti-polysaccharide antibodies. Results. The study was conducted on 30 patients (15 female, 15 male): 28 had marasmus, and 2 had kwashiorkor. The mean age was 24.11 months; a small thymus was found in 15/30; and 3 patients had lymphopenia. A low number of CD19 lymphocytes were found in 27% of the patients; 24% did not produce antibodies against pneumococcal polysaccharides. The CD3, CD4, CD8, and CD16+56 lymphocytes were decreased in 11, 15, 8, and 6 patients, respectively; an inverted CD4/CD8 ratio was found in 40% of the patients. Abnormal lymphoproliferation was found in 7%; 30% had decreased C3; and 23% had decreased C4. Micronutrients were decreased in the follow percentages of patients: Fe 53%, Zn 17%, Cu 7%, and Se 13%. A statistically significant Pearson correlation was found between B12 and C4; between vitamin E and CD3, CD4, and CD19; between iron and CD3, CD8, and NK; and between Cu and C3 and IgG. Conclusions: Previously unpublished data are presented in this study: decreased CD19 levels in 27% of the patients, abnormal response to polysaccharides in 24%, and abnormal lymphoproliferation in 7%.

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