TY - JOUR T1 - Lower lymphocyte response in severe cases of acute bronchiolitis due to respiratory syncytial virus JO - Anales de Pediatría (English Edition) T2 - AU - Ramos-Fernández,José Miguel AU - Moreno-Pérez,David AU - Antúnez-Fernández,Cristina AU - Milano-Manso,Guillermo AU - Cordón-Martínez,Ana María AU - Urda-Cardona,Antonio SN - 23412879 M3 - 10.1016/j.anpede.2017.07.005 DO - 10.1016/j.anpede.2017.07.005 UR - https://analesdepediatria.org/en-lower-lymphocyte-response-in-severe-articulo-S2341287918300656 AB - IntroductionAcute bronchiolitis (AB) of the infant has a serious outcome in 6–16% of the hospital admitted cases. Its pathogenesis and evolution is related to the response of the T lymphocytes. The objective of the present study is to determine if the lower systemic lymphocytic response is related to a worse outcome of AB in hospitalised infants. Patients and methodRetrospective observational-analytical study of cases–controls nested in a cohort of patients admitted due to RSV-AB between the period from October 2010 to March 2015. Those with a full blood count in the first 48h of respiratory distress were included. Infants with underlying disease, bacterial superinfection, and premature infants <32 weeks of gestation were excluded. The main dichotomous variable was PICU admission. Other variables were: gender, age, post-menstrual age, gestational and post-natal tobacco exposure, admission month, type of lactation, and days of onset of respiratory distress. Lymphocyte counts were categorised by quartiles. Bivariate analysis was performed with the main variable and then by logistic regression to analyse confounding factors. ResultsThe study included 252 infants, of whom 6.6% (17) required PICU admission. The difference in mean±SD of lymphocytes for patients admitted to and not admitted to PICU was 4044±1755 and 5035±1786, respectively (Student-t test, P<0.05). An association was found between PICU admission and lymphocyte count <3700/ml (Chi-squared, P=0.019; OR: 3.2) and it was found to be maintained in the logistic regression, regardless of age and all other studied factors (Wald 4.191 P=0.041, OR: 3.8). ConclusionsA relationship was found between lymphocytosis <3700/ml in the first days of respiratory distress and a worse outcome in previously healthy infants <12 months and gestational age greater than 32 weeks with RSV-AB. ER -