Medicine
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This repository contains the published and unpublished research of the Faculty of Medicine by the staff members of the faculty
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Item Persistent, poorly responsive immune thrombocytopenia secondary to asymptomatic COVID-19 infection in a child(Hindawi, 2023) Mettananda, C.; Williams, S.Immune thrombocytopenic purpura (ITP) secondary to asymptomatic COVID-19 infection, especially in children, is not reported. Furthermore, persistent, treatment-resistant ITP secondary to COVID-19 is not reported. We report a previously healthy 14-year-old Asian boy who developed secondary ITP following an asymptomatic COVID-19 infection and is having a relapsing and remitting cause with poor response to immunosuppressants even after 21 months following the diagnosis. This case emphasizes the importance of testing for COVID-19 in newly diagnosed ITP patients and the need for follow-up platelet counts in patients who recover from COVID-19 as it may follow into developing secondary ITP yet being asymptomatic until you present with a bleeding complication of ITP. The poor response to standard immunosuppression warrants more understanding of the pathophysiology of persistently low platelets following COVID-19 infection. Long-term sequelae of the disease highlight the importance of getting vaccinated for COVID-19 despite COVID-19 being no longer a global emergency.Item The effect of nutrition on immune response in active pulmonary Tuberculosis(Sri Lanka College of Microbiologists, 2006) Wijesuriya, M.T.W.; Weerasinghe, A.INTRODUCTION: Studies identifying the active components of immune response against TB should consider the confounding effects of malnutrition and anaemia, which are known to impair cell-mediated immunity. OBJECTIVES: To compare nutritional status (malnutrition and anaemia) and immune status (lymphocyte subpopulations) of patients with Active Pulmonary Tuberculosis (ATB) with healthy controls 2.To describe the effect of nutritional status on immune response to ATB. METHODS: A cross-sectional, comparative study involving 49 smear-positive TB patients (41 males, median age 35 yrs) and 49 controls (25 males, median age 34yrs) was carried out. Persons with immunosuppress!on (HIV infection, diabetes mellitus, corticosteroid or immunosuppressive therapy) or on nutritional supplementation were excluded. Nutritional status was assessed using anthropometry, haemoglobin and red-cell indices. Labeled monoclonal antibodies against lymphocyte surface markers were used in dual parameter flow-cytometry to quantify (cells/mm3) total T(CD5), T-helper(CD4), T-cytotoxic(CDS), B(CD19), B1(CD19+CD5), Natural-killer(CD56), Natural-Killer-T(CD56+CD3)lymphocytes. Student t-test or Kruskal-wallis test for 2 groups was used where appropriate. p<0.05 was considered significant. RESULTS: Whilst nutritional status assessed by weight (43 vs 57 kg, p<0.001), mid-arm circumference (21.1 vs 27.6 cm, p<0.001) and body mass index (16 vs 20.7 kg/m2, p<0.001) was lower in ATB, anaemia was greater (61.2% vs 12.2%, p<0.001). Means of total lymphocytes (2,475 vs 3,211; p<0.0001) and most lymphocyte subsets (T, CD4, CDS, B and Bl cells) were significantly lower in patients with ATB (n-49) compared to controls (n=49). There was no statistically significant difference in the total lymphocytes, T, CD4, CDS, B, Bl, NK and NKT cells in undernourished TB patients (BMI< 18.5) and anaemic TB patients compared to well-nourished and non-anaemic TB patients. CONCLUSIONS: Malnutrition and anaemia observed in ATB does not have an impact on the peripheral depletion of lymphocyte subsets.