Dr. Stiehm supported Dr. Chandra's study with some details about his own investigations in Ghana. He pointed out that there is a decrease of T lymphocytes in kwashiorkor and marasmus and that these cells seem unusually susceptible to nutritional insult. Dr. Katz asked whether it was the diminished survival or diminished production of the T cells that was responsible for this decrease. Dr. Stiehm expressed the view that it was almost certainly diminished production, since malnourished children have small tonsils and are lymphopenic. However, he added that turnover studies have not been done.
A discussion then followed among Drs. Béhar, Stiehm, Lechtig, and Mata regarding the meaning of elevated IgM level in cord serum. It was suggested that not all instances of IgM level elevation are due to infection, but some may be caused by another stimulus, such as damage to placental vessels. Moreover, if samples of cord blood are