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Pediatría (Asunción)

versão On-line ISSN 1683-9803

Resumo

SANABRIA, Diana; GIMENEZ, Vivian; CARPINELLI, María Mercedes  e  MARTINEZ DE CUELLAR, Celia. Neutrophil`s respiratory burst by nitroblue tetrazolium (NBT) and dihydrorhodamine (DHR) techniques in children with clinical suspicion of chronic granulomatous disease (CGD). Pediatr. (Asunción) [online]. 2017, vol.44, n.1, pp.49-55. ISSN 1683-9803.  https://doi.org/10.18004/ped.2017.abril.49-55.

Introduction:

The neutrophil`s respiratory burst (RB) is essential for the defense against infections, this process is absent or ineffective in the CGD, a primary immunodeficiency (PID) diagnosed by the NBT test. Techniques that used flow cytometry such as DHR, performed only at the Instituto de Investigaciones en Ciencias de la Salud (IICS), currently stand out, having been applied only to healthy children.

Objective:

To evaluate the neutrophil`s RB using the NBT and DHR techniques in children with clinical suspicion of CGD and to describe their clinical and demographic characteristics.

Materials and methods:

36 children of both sexes, with less than 17 years of age, that were referred to the IICS by specialists physicians between the years 2014-2015 were included. A blood sample was obtained to evaluate the neutrophil`s RB and a questionnaire was applied.

Results:

The median age was of 4 years and 56 % were males. Predominantly the patients were hospitalized, being sepsis and cutanueos furunculosis the most frequent clinical manifestations and a 72 % presented recurrent infection with a median of 3 episodes/year. The average for the neutrophil´s stimulation index (EI) was 38,1±13,7 with the DHR test, and 87±17% of activation for the NBT test. In 8 patients the values obtained were below the ones considered as normal and in one child CGD was confirmed, in which an X-linked inheritance pattern was observed.

Conclusion:

The evaluation of the neutrophil`s RB allowed the detection of one case of CGD, and the inheritance pattern was determined by the DHR test for the first time in our country. The use of available diagnostic tools in children with clinical suspicion of PID is essential for the appropriate detection and treatment that improve the quality of life and reduce mortality.

Palavras-chave : respiratory burst; neutrophils; NBT; DHR; flow cytometry; CGD; X-linked inheritance..

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