Science- Research Institute of Pediatrics named after K.Y. Farajeva, Baku, AZERBAIJAN
Issues: The emergence, development, course and outcome of chronic viral hepatitis are largely depend on perfection of both cellular and humoral parts of specific immunity mechanisms
Description: We have studied indictors of the humoral immunity in 27 children at the age of 18 months with chronic hepatitis B and born to mothers with viral hepatitis B (HBV). The studied patients were divided into two groups depends on degree of the decease activity. The activity of the pathology process of the 11 children (40,7%) was moderate , 16 children (59,3%) had minimal activity. As control indicators were used humoral immunity indicators of the 15 healthy children of the same age.
Results: The research determined some features of immunoglobulin classes A, F and G productsĺ in serum. The levels of all immunoglobulinĺs classes among patients with both minimum and moderate activity of the process were significantly differed from the control group indicators. Thus, moderate activity of the cytology process in the liver was accompanied by a significant decrease of Immunoglobulin A(IgA) (0,33▒0,07 g/l against 0,70▒0,08 g/l in control group, <0,05) ; and increase of Immunoglobulin ╠ (IgM) (1,42▒0,27 g/l against 0,53▒0,07 g/l in control group , <0,001); and Immunoglobulin G (IgG) (8,97▒0,68 g/l against 5,81▒0,64 g/l in control group , <0,05) in blood serum. In condition of the minimal activity of process, the degree of IgA remained within normal limits (0,61▒0,06 g/l , >0,05) with increased production of the IgM (1,23▒0,34 g/l , <0,001) and IgG (5,81▒0,64 g/l, <0,05). It was determined the normal level B -lymphocytes in peripheral blood among the patient with moderate activity of the process (24,55▒2,28% against 23,68▒2,75% in control group , >0,05) and B -lymphocytes decrease in peripheral blood among the patients with minimal activity of the process (15,61▒1,20% against 23,68▒2,75% in control group , <0,05).
Conclusions: Thus, analysis of the study results showed the significant imbalance of the humoral part of the immune status regarding both immunoglobulins and B-lymphocytes among the children with chronic HBV infection.
THE EFFECT OF OBESITY, DYSLIPIDEMIA AND DIABETES MELLITUS ON THE RISK OF POST-ERCP PANCREATITIS
A.KADAYİFCİ , T. BABACAN, I. KORUK, M. AYDİNLİ, C. SAVAS , M. KORUK
Gaziantep University, Gaziantep, TURKEY
Introductıon: Acute pancreatitis is the most common complication of ERCP. The effect of metabolic conditions such as obesity, dyslipidemia and diabetes mellitus (DM) on post-ERCP pancreatitis (PEP) is not clear.
Aıms & Methods: The aim of the study was to evaluate the effect of these factors on the frequency and severity of PEP. A total of 1329 naive patients, who underwent an ERCP during 2009-2010 in a single tertiary referral centre, were evaluated prospectively for the frequency and severity of PEP based on the consensus criteria. The patients with a history of acute pancreatitis in last 4 weeks were excluded. The patients with obesity (BMI>30), dyslipidemia (triglyceride > 200mg/dl or LDL-cholesterol >160mg/dl) and DM (history of DM or fasting glucose level >126 mg/dl) were find out before the procedure. The rate of PEP compared separately between patients with and without of these metabolic conditions. The all well-defined risk factors for PEP were also recorded and compared between groups.
Results: The rate of obesity, dyslipidemia and DM was 20.5%, 31.9% and 16% respectively in the study group. The PEP was developed in 51 patients with an overall incidence of 3.8%. The rate of PEP was 5.5% in patients with obesity, 5.4% in patients with dyslipidemia and 7.5% in patients with DM. Although PEP was more frequent in all 3 groups, only the rate in patients with DM was statistically significant compared to PEP rate in patients without DM (7.5% vs. 3.1%, p=0.002, OR=2.51, RR=2.40). Sixteen of 51 patients with PEP had DM. The rate of DM in patients with PEP was significantly higher than the study population (31.3% vs. 16%, p=0.006, OR=2.4). The severity of pancreatitis was not affected by obesity and dyslipidemia. The severe pancreatitis were detected more frequently in patients with DM compared to without (19% vs. 9%, p=0.27) but result did not reach a statistical significance. The well-defined other risk factors of PEP were comparable among the study groups.
Conclusıon: DM has been found as an important risk factor for PEP in this study. It might also affect the clinical course of disease. These patients should be better evaluated and monitored for PEP. The role of obesity and dyslipidemia as the risk factors of PEP needs further evaluation.