Immunosuppression in patients with severe acute pancreatitis

Abstract

Immunosuppression occurs from the early phase in SAP, and quantitative impairment of lymphocytes, mainly T lymphocytes, may be closely related to infectious complications during SAP. CD4- and CD8-positive lymphocyte counts on admission and the lymphocyte count on day 14 after admission may be useful for predicting infection.

Acute Pancreatitis in Patients Living with HIV

“…There is also evidence of an association with higher viral loads, suggesting that those with more advanced disease are at greater risk. Dragovic [3,9,18,19], the AP had occurred in our study in patients with acute immunosuppression with CD4 count less than 200 cells/mm 3 . Nadembèga affirms that the average rate of amylasemia is higher in patients with stage C than those in stage A and B (CDC classification).…”

“…Moore et al had reported a risk increase in patients receiving nucleoside reverse transcriptase inhibitors (NRTIs), especially didanosine [23]. Prolonged exposure to these molecules is associated with inhibition of DNA polymerase, the enzyme responsible for mitochondrial DNA replication, causing mitochondrial toxicity [4,18,24]. Under protease inhibitors especially in Lopinavir and Ritonavir, the AP is explained rather by the secondary hypertriglyceridemia, which is due to the decrease in peripheral clearance of triglycérides [25,26].…”

Changes in Adaptive and Innate Immunity in Patients with Acute Pancreatitis and Systemic Inflammatory Response Syndrome

“…However, apoptosis of CD4 lymphocytes was not related to the late resolution of SIRS. Lymphopenia arising in acute pancreatitis of either mild or moderate severity has also been described in other cohorts of patients [19,20]. …”

Acute pancreatitis in HIV/AIDS patients: an issue of concern

“…The risk of pancreatitis is increased for the HIV/AIDS patients with lower CD4 cell counts [36] . There is also evidence of an association with higher viral loads, suggesting that those with more advanced disease are at greater risk [17,21,35] .…”