Avaliação clínica, laboratorial e citogenética de pacientes com Síndrome de Down vacinados com vacina pneumocócica polissacarídica 23 valente: um estudo retrospectivo

Abstract

Introduction: individuals with Down syndrome (DS) have a higher frequency of infections, suggesting that there may be immunological changes in this population. Objective: to evaluate the immune response profile in children with DS in order to recognize possible immune dysfunctions associated with recurrent infection. Material and methods: retrospective analysis of 54 patients with DS treated at the Hospital de Clínicas of the Federal University of Uberlândia from 2016 to 2019. Epidemiological, clinical, cytogenetic and laboratory variables were studied. Results: the sample consisted of patients aged between 2 and 20 years, with a predominance of males. In the chromosomal study, simple trisomy was the most common. Among the pathologies associated with DS, cardiac and endocrine alterations were mainly observed. Immunoglobulin (Ig) M and G levels were considered normal, while IgA levels, although normal, were significantly lower in patients with DS and recurrent infection. CD3+, CD4+, CD8+ T lymphocyte numbers were age appropriate, while CD19+ B lymphocyte levels were slightly reduced. In the analysis of the production of antibodies to pneumococcal polysaccharide antigens after immunization, we found that patients with DS and recurrent infections seroconverted significantly less than the group without infection. Conclusion: patients with DS present a variability of comorbidities and the deficiency of antipolysaccharide antibodies can be an important factor of immunological compromise predisposing to sinopulmonary infections and should be routinely evaluated in patients with DS and recurrent infections.