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Immunocompetence of Patients with Protein-Calorie Malnutrition: The Effects of Nutritional Repletion

[+] Article, Author, and Disclosure Information

Grant support: grant 642-30, Veterans Administration; and grant A1-00319, U. S. Public Health Service. Dr. Law was the recipient of the 1972 AMA Joseph Goldberger medical student research fellowship.

Presented in part at the annual meeting of the Association of Academic Surgery, November 1972, New Orleans, Louisiana.

▸Requests for reprints should be addressed to N. I. Abdou, M.D., 517 Johnson Pavilion, School of Medicine, University of Pennsylvania, Philadelphia, PA 19174.

Philadelphia, Pennsylvania

Ann Intern Med. 1973;79(4):545-550. doi:10.7326/0003-4819-79-4-545
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Both the thymus (T)- and bone marrow (B)-dependent immune systems were evaluated in 18 adults with protein-calorie malnutrition and in 12 control patients. Seven of the 18 malnourished patients received intravenous hyperalimentation for 18 days, and their immune competence was then compared with that before treatment. Serum immunoglobulin levels were unaffected by the malnutrition or the treatment. The T system, assessed by either delayed skin reactivity to primary and secondary antigens or in-vitro lymphocyte responses to phytohemagglutinin, was impaired in patients with protein-calorie malnutrition. The B system, evaluated by measurement of early serum IgM antibody response to keyhole limpet hemocyanin was also impaired in these patients. Intravenous hyperalimentation resulted in improvement of delayed skin reactivity and lymphocyte responses to phytomitogens. Apparently, both the T and B systems are impaired in adults with moderate protein calorie malnutrition, and nutritional repletion will improve their immunocompetence.





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