Coovadia H M, Wesley A, Brain P
Arch Dis Child. 1978 Nov;53(11):861-7. doi: 10.1136/adc.53.11.861.
77% of 30 children with measles who had severe lymphopenia (less than 2000/mm3; less than 2.0 x 10(9)/1) within 2 days of appearance of rash (group A) subsequently died or progressed to chronic chest disease. This was significantly worse than the outcome in 30 children with measles who had lymphocyte counts more than 2000/mm3 (more than 2.0 x 10(9)/1) (group B) of whom 67% recovered. In group A children the persistence of severe lymphopenia (caused by a reduction in T- and B-cells) for at least 15 days after onset of rash, remained a good predictive index of morbidity and mortality. Reversal of immunoparesis in group A was slower and incomplete 42 days from appearance of the rash in those who subsequently died or developed chronic chest disease compared with those who recovered. All patients who died failed to produce adequate measles antibodies. The therapeutic implications and immunopathological significance of these findings for chronic complications after acute measles are discussed.
在出疹后2天内出现严重淋巴细胞减少（低于2000/mm³；低于2.0×10⁹/L）的30例麻疹患儿（A组）中，77%随后死亡或发展为慢性胸部疾病。这明显比30例淋巴细胞计数高于2000/mm³（高于2.0×10⁹/L）的麻疹患儿（B组）的结局更差，B组中有67%康复。在A组患儿中，出疹后严重淋巴细胞减少（由T细胞和B细胞减少引起）持续至少15天，仍然是发病率和死亡率的良好预测指标。与康复的患儿相比，A组中那些随后死亡或发展为慢性胸部疾病的患儿，从出疹起42天免疫麻痹的逆转更缓慢且不完全。所有死亡的患者均未能产生足够的麻疹抗体。本文讨论了这些发现对于急性麻疹后慢性并发症的治疗意义和免疫病理学意义。
