Urinary Secretory Iga In Malnourished Children With Chronic Diarrhea:

Sahar Mahmoud Abd El-salam El-gendy

Secretory 19A, is contributing to the local protection of themucosal surfaces against infection with various microorganisms.The aim of this work was to estimate IgA level in urine andserum of infants and children complaining malnutrition and malnutritionwith chronic diarrhea and to compare results to the healthy wellnourihed children. The study was conducted on 50 infants and children(28 boys and 22 girls) their ages ranged from 8-36 monthes. They werecatigorized into 3 groups, The first group consisted of 20 malnourishedchildren with chronic diarrhea The second group was 20 malnourishedchildren without diarrhea and lastly 10 healthy normally nourishedchildren who represented the third and control group. The workadmited at Benha Faculty of Medicine HospitalAIl cases were subjected to complete history taking, firl] clinicalexamination and laboratery investigations inclUding complete urine andstool analysis, urinary creatinine and secretory IgA out put andconcentration estimation and serum IgA concentration estimation.Provided that the reults of stool analysis of the control h’TOUpwerenormal and that of urine analysis of all cases were free. The results ofstool analysis in group I showed protOzoal and parasitic infestation in55% of cases and for group II 35% affection. The majority of caseswere affected with Giardiasis also Amaebiasis, Hymenolepis Nana ,Ascariasis> Ancylestomiasis and oxyuris were found .Urinary creatinine out put in 6 hours showed no significantdifference between any 2 groups of our 3 studied groups.As regards unnary SlgA out put its mean was about 4.7 timeshigher in malnourished children with chronic diarrhea (group I) than inmalnourished children without diarrhea (group II) with highlysignificant difference (P < 0.001). It was about 2.3 times higher thanthat of nonnally nourished control (group III) also, the difference washighly significant (P < 0.001 ). On the other hand group II its mean ofurinary SlgA out put was about 1/2 that the group III, that lowering isalso statistically highly significant (P 0.05) but there was highly significant elevation in its levelIII malnourished children with chronic diarrhea group I when comparedto that of those malnourished without diarrhea group II or that ofcontrol group (P < 0.001).There was no correlation between urinary SIgA and serum IgAconcentration in the three groups meaning that secretory IgA isproduced locally at mucosal sites and its production is not dependenton circulatory IgA.from these results we concluded that : There is selectivereduction of secretory IgA in urine of malnourished children but despitethis reduction in SIgA production, malnourished children retain thecapacity to mount a mucosal response to infection. The secretory IgAproduction at one location can be stimulated in response to infection atanother mucosal site suggesting that there is a communication betweendifferent secretory tissues of the body, a finding that is supporting thehypothesis of a common secretory immune system.