0
We're unable to sign you in at this time. Please try again in a few minutes.
Retry
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
Retry
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Article |

Anergy in Pediatric Head Trauma Patients

Nevin W. Wilson, MD; Ann Gooding, MD; Bradley Peterson, MD; John F. Bastian, MD
Am J Dis Child. 1991;145(3):326-329. doi:10.1001/archpedi.1991.02160030096029.
Text Size: A A A
Published online

• To assess cellular immune function in children following severe blunt trauma, 25 children (mean: age, 7.1 years; Injury Severity Score, 34.9; and Glascow Coma Score, 5.6) admitted with severe trauma were examined with the use of the CMI Multitest system (Merieux Institute, Miami, Fla) to test delayed-type hypersensitivity. Patients were monitored for evidence of infection for the next 3 weeks. Ten children (mean: age, 6.2 years; Injury Severity Score, 31.2; and Glascow Coma Score, 5.4) admitted with severe trauma had the percentage of circulating lymphocyte subpopulations (pan—T cell marker T101, CD4, CD8, and B cells) measured on day 1 and then weekly for 3 weeks. Fourteen (56%; of the 25 children had no reaction to any of the skin tests (anergic). Eleven (79%) of 14 anergic patients became infected, while three (27%) of 11 of the nonanergic children became infected. There were no significant changes in pan—T cell marker T101, CD4, or CD8 lymphocyte populations in the 3 weeks following injury; however, absolute numbers of circulating B cells dropped significantly by day 7. These data indicate that children with severe trauma who are anergic are significantly more susceptible to infection. Unlike the results reported previously in adult trauma patients, these children had no significant fluctuations in T-cell populations; however, there was a significant decrease in circulating B cells in the first week. The use of the delayed-type hypersensitivity skin test can aid in identifying which patients are at an increased risk for nosocomial infection.

(AJDC. 1991;145:326-329)

Topics

Sign in

Create a free personal account to sign up for alerts, share articles, and more.

Purchase Options

• Buy this article
• Subscribe to the journal

Figures

Tables

References

Correspondence

CME
Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
Submit a Comment

Multimedia

Some tools below are only available to our subscribers or users with an online account.

Sign in

Create a free personal account to sign up for alerts, share articles, and more.

Purchase Options

• Buy this article
• Subscribe to the journal

Related Content

Customize your page view by dragging & repositioning the boxes below.

Jobs
brightcove.createExperiences();