IMMUNE DYSREGULATION IN PEDIATRIC RECURRENT TONSILLITIS: A CASE-CONTROL STUDY ON IMMUNE PROFILES AND INFLAMMATORY MARKERS.

JPUMHS;2024:14:04,152-161. http://doi.org/10.46536/jpumhs/2024/14.04.573

Abstract

BACKGROUND: Recurrent tonsillitis, characterized by repeated tonsillar inflammation,
significantly affects children's quality of life, leading to missed school days, sleep
disturbances, reduced participation in daily activities, and emotional distress, and is
frequently linked with immune dysfunction. Limited data from developing countries like
Pakistan hinders understanding its immunological basis, specifically variations in immune
response in the pediatric age group. This study explored the association between recurrent
tonsillitis and immune dysregulation to guide diagnosis, treatment, and prevention strategies.
OBJECTIVES: The study aimed to investigate the association between immune
dysregulation and recurrent tonsillitis in children focusing on immunological profiles and
mechanisms. STUDY DESIGN: Case-control study SETTING & DURATION:
Department of ENT, Hameed Latif Teaching Hospital Lahore, from 25-6- 2024 to 25-11-
2024. METHODS: In this study, 152 participants were included. Among these participants,
102 children were diagnosed with recurrent tonsillitis cases, and 50 healthy controls of
similar age groups were enrolled using consecutive sampling. The calculated sample size at
50% probability, with a 5% margin of error and 95% confidence interval; participants were
categorized into specific age groups 3–5, 5–8, 8–10, and 10–12 years to capture variations
across different growing ages of Pediatrics. Immune parameters assessed were white blood
cell count WBC, neutrophils, lymphocytes, monocytes, eosinophils, plasma IgG, IgA, and
IgM levels. Statistical analysis was performed using SPSS version 25, with significance at p
< 0.05. RESULTS: The mean age of participants was 7.5 ± 2.887 years. Children with
recurrent tonsillitis had significantly higher WBC counts 12,770 cells/µL in cases vs. 6,500
cells/µL in controls and elevated neutrophil, lymphocyte, and monocyte counts, suggesting
heightened immune response. Serum IgG levels were significantly elevated in cases 1330
mg/dL compared to controls 1015 mg/dL, and serum IgA levels were also significantly
higher, indicating an ongoing inflammatory response and immune dysfunction.
CONCLUSION: This study highlights immune dysregulation as a key factor in pediatric
recurrent tonsillitis. Elevated WBC, neutrophil, lymphocyte, monocyte counts, and serum
IgG and IgA levels suggest elevated inflammatory response. Comprehensive immunological
evaluation can aid in adopting preventive and effective strategies for management and
prevention.