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  • Title: Study of Serum Immunoglobulin Levels and T lymphocyte Subsets in Children with Beta Thalassemia with Iron Overload in Egypt.
    Author: Hagag AA, Elgamasy MA, Abd Elbar ES.
    Journal: Egypt J Immunol; 2016 Jan; 23(1):97-105. PubMed ID: 28502157.
    Abstract:
    Beta thalassemia is an inherited hemoglobin disorder resulting in chronic hemolytic anemia that requires lifelong transfusion therapy. Repeated blood transfusions and RBCs hemolysis are the main causes of iron overload, which in addition to immune abnormalities, are common predisposing factors to infection in patients with thalassemia. The aim was to study serum immunoglobulin levels and T lymphocyte subsets in children with beta- thalassemia in relation to iron overload. This study was conducted on 40 children with beta thalassemia major including 24 males and 16 females with mean age of 9.22 ± 3.9 and 20 healthy children of matched age and sex as a control. All children were subjected to assessment of infection episodes, complete blood picture, Hb electrophoresis, serum iron status, T cell subsets including CD3, CD4 and CD8 using Becton Dickinson FAC Scan flow cytometer and serum immunoglobulin levels including IgM, IgA and IgG by a commercial nephelometry assay using a BN-II device. Serum ferritin and iron were significantly higher but total iron binding capacity was significantly lower in patients than controls (Mean serum ferritin was 3418.23±2950.7 in the studied patients versus 39.48±2.48 in the control group with p value of 0.00, mean serum iron was 222±56.61 in the studied patients versus 90±31.87 in the control group with P value of 0.00 and mean serum total iron binding capacity was 198.38±19.9in the studied patients versus 315.7±24.85 in the control group with P value of 0.00). CD3 and CD4 were significantly lower but CD8 was significantly higher in patients than controls. The count (mean ± SD cells/ mm2) for CD3+, CD4+ and CD8+ T cells in patients was 1733.25 ± 381.87, 889.67 ± 282.86 and 779.72 ± 390.63 respectively as compared to 1887 ± 390.56, 1003 ± 250.96 and 663 ± 116.71 in the control group respectively (P values 0.00, 0.048 and, 0.02 respectively). The mean ± SD (mg/dl) of serum immunoglobulin's G, M and A showed significant variation between patients and controls including significantly lower IgM and significantly higher IgG, and IgA in patients than controls with P values of 0.014, 0.049 and 0.020 for G, M, and A respectively).There were significant negative correlations between CD3, CD4, IgM and ferritin and significant positive correlations between CD8, IgG, IgA and ferritin. In conclusion; Iron overload affects humeral and cell mediated immunity in thalassemic patients therefore regular follow up for iron overload is recommended.
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