Department of Paediatrics, University Hospitals of Leicester, Leicester, UK.
Arch Dis Child. 2012 May;97(5):478-80. doi: 10.1136/archdischild-2011-300691. Epub 2012 Jan 30.
The prevalence and clinical significance of specific polysaccharide antibody deficiency (SAD) in children are poorly understood. The authors sought to determine the prevalence of SAD in children with chronic wet cough, through a retrospective study of all children with chronic wet cough attending our tertiary respiratory clinic over a 12-month period. Antibody levels to 13 pneumococcal serotypes were measured following vaccination with the unconjugated pneumococcal polysaccharide vaccine, Pneumovax II, and clinical data were reviewed. Twenty-four children over 2 years of age with chronic wet cough were vaccinated. Fourteen (58%) failed to mount an adequate antibody response, consistent with SAD. Children with SAD were more likely than children with normal antibody responses to require intravenous antibiotics (p=0.035) and to have abnormal chest radiographs (p=0.029). The authors conclude that SAD is present in a significant number of children with chronic wet cough. The clinical significance and long-term outcome of SAD warrant further investigation in prospective studies.
特定多糖抗体缺陷症（SAD）在儿童中的流行情况及其临床意义尚不清楚。作者通过对在 12 个月内到我院三级呼吸科就诊的所有慢性湿性咳嗽患儿进行回顾性研究，旨在确定 SAD 在慢性湿性咳嗽患儿中的患病率。在接种非结合型肺炎球菌多糖疫苗（Pneumovax II）后，测定了针对 13 种肺炎球菌血清型的抗体水平，并对临床数据进行了回顾。对 24 名 2 岁以上的慢性湿性咳嗽患儿进行了疫苗接种。其中 14 名（58%）未能产生足够的抗体反应，符合 SAD 的特征。与抗体反应正常的患儿相比，SAD 患儿更有可能需要静脉用抗生素（p=0.035），且胸部 X 线检查异常的可能性更高（p=0.029）。作者得出结论，SAD 在大量慢性湿性咳嗽患儿中存在。SAD 的临床意义和长期预后需要在前瞻性研究中进一步调查。
