Assessment Of Cd4&cd8 Ymphocytes In Paediatic Shronic Liver Diseases Using Flow Cytometry:

Haitham Abbas El Hadidy

Many theories on the sequence of events leading to the developmentof chronic liver disease are centered on defect in T cell function (Dudly etal., 1972).This study was carried out to assess CD4, CDg and CDJCDg ratio inchildren with chronic liver diseases using flowcytometry technique and toevaluate the superiorty of such technique prior to older methods.Material of this study included 30 patients attending the pediatricgastoenterology unit, using flowcytometer, of the hematology department,central Medical research laboratories, of the Armed forces.Patients were classified into 15 cases which are chronic viralhepatitis, and 15 cases which are chronic bilharzial hepatitis.Careful clinical examination, liver function tests, hepatitis viruesmarkers, abdominal sonography were done. All the thirty cases and Tencontrols are investigated for CD4 (T.helper),CD8 (T suppressor/cytotoxic)and CD4/CD8 ratio (helper/suppressor ratio).Considering the liver function tests the serum bilirubin wereelevated in the studied group in 33% cases with chronic viral hepatitis, and13.3% in cases with chronic bilharzial hepatitis with highest level inchronic viral hepatitis group.The serum transminases Got were elevated in 66% of cases withchronic viral hepatitis, GPT in 40%, alk. Ph in 33.3% and GGt in 46.6%,but in Got in cases with chronic bilharzial hepatitis GOT were elevated in26% of cases, GPT in 20%, Alk.ph in 20% and GGt in 33.3% with highestlevel in chronic viral hepatitis, group.As regard markers in chronic viral hepatitis group 20% of childrenwere HBsAg +e, 86% HBsAb +ve, 46.6% HBcAb +ve, 20% HBeAg +ve,26.6% HBeAb +ve and that 26.6% had HCV Ab marker in their serum.This indicate that most etiologic agent in chronic viral hepatitischildren were hepatitis B virus more than other hepatitis virus.In chronic viral hepatitis group the CDs positive cells wereincreased so CDJCDs ratio were decreased in comparison to controlgroup the difference between the studied groups were statisticallysignificant (p<0.01).In comparison between chronic bilharzial hepatitis the CD4 positivecells were increased CDs positive cells were decreased in those cases withcirrhosis so CDJCDg ratio were increased in comparison to chronic viralhepatitis group. The differences between the studied groups werestatistically significant (p < 0.01).To examine large number of cells within short period of time, it wasnecessary to pass cells at a high speeds through analytic and sensingdevices. This goal was achieved with the construction offlow cytometers.