الفهرس 
Materials and methodsOnly 14 pages are availabe for public view
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Abstract
Malnutrition represents a major health problem in
many developing countries and it usually affects infants
and children from 6-36 months.
In many studies, the effect of malnutrition on the
integrity of the immune system has been investigated.
The aim of this work was to study some immunological
factors in serum of PCMchildren which are affected by
the disease and their effects on the normal phagocyt ic
response.
67 children of both sexes with an age range of
3-36 months and suffering from different forms of PCM
were studied together with 21 normal healthy children
as controls.
Those children were selected
attending the out patient clinics
Medicine and investigated in the
1988 and June 1990.
from the patients
of Benha Faculty of
period between June
The c 1in ical
history including
and immunizations.
status was assessed through full
nutritional data, growth parameters
Also, ’t he se children were examined
clinically with stress upon weight, anthropometr ic
measures, concomitant infections and signs of PCM.
PCMchildren were classified according to Wellcome
classification, 1970 into Kwashiorkor, marasmic Kwashiorkor
and marasmus groups.The number of cases were 21, 17
and 29 cases respectively.
The subjects of this study were tested for serum
immunoglobulins levels (IgG, IgM, IgA, IgE and IgD),
complement component C3, circulating immune complex
CIC, measles and tetanus antibodies and for opsonic
activity of serum. The achieved results of PCMchildren
were compared to those of control group.
In this study serum IgM, A and E were elevated in
PCMchildren and this elevation could be attributed to
concomitent infection. Also serum IgD was elevated and
was not related to infection.
Serum C3 levels were depressed in all PCMgroups.
This depression was not canpletely related to the associat~
d infections, still its levels were lower in the
sever forms of infections associated with malnutrition.
Also these decreased levels of C3 were affected by the
severity of malnutrition, as cases of Kwashiorkor have
the lowest levels followed by cases of marasmic Kwashiorkor
then marasmic children.
CIC levels were e l evat.ed with PCMand correlated negatively with opsonization showing that it may be
a factor affecting phagocytosis in these children. CIC
was also correlated positively with measles antibodies
that could be responsible for the elevated levels of
CIC, which in turn affect immunity. CIC was correlated
negatively to Cr CIC can trigger to activation of
complement system, so may aid in C3 depletion present
in PCM.
In this study opsonic activity of serum was affected
by Kwashiorkor. Infection seems to be a factor as
cases associated with infection showed lower opsonic
activity of their serum. Also cases associated with
infection have lower levels of serum antibodies against
tetanus and measles. Measles antibodies were affected
more by the severity of infection as cases with mixed
respiratory infection showed the lowest levels of these
ant ibod ies.
Serum antibodies against measles were depressed in
all PCM groups. While those against tetanus was not
affected by malnutrition.
from this study it was concl uded that:
Humoral immunity is affected by PCM especially
serum C3’ and antibodies against measles.
Infection plays a role in morbidity of peM as it
shareS in depression of serum antibody response
against tetanus and measles.
vaccination of PCM children, especially during
infections is better to be postponed untill recovery.
Measles immunization in PCM children is better to
be delayed untill correction of malnutrition.
CIC plays a role in disease production in PCM
children and this role needs further studies to be
clarified.