Cleft Nucleus Lymphocytosis in Young Infants with PertussisFunding None.
This study aims to assess whether the cleft nucleus lymphocytosis could be an early promising clue for the diagnosis of pertussis in young infants. Pertussis (whooping cough) is a severe respiratory disease mainly caused by Bordetella pertussis infection and is characterized by a significant rise in the number of leukocyte and lymphocyte in infants and young children. In this study, the Bordetella pertussis DNA was detected from samples of pharyngeal swab by PCR assay. Levels of serum specific IgM against other respiratory pathogens were detected by Enzyme-linked immunosorbent assay (ELISA) assay. The routine blood test including numbers of leukocytes, lymphocytes, and platelets etc. were tested by automatic hemocyte analyzer (Sysemx XN1000). Besides, the morphology of leucocytes was observed in peripheral blood smear with microscope by Wright-Giemsa stain. Three cases of pertussis with cleft nucleus lymphocytes in young infants were discussed in in the neonatal/pediatric intensive care unit in our hospital. Leukocytosis characterized by lymphocytes, as well as thrombocytosis were observed in all patients. Our results demonstrated that cleft nucleus lymphocytosis accompanied with leukocytosis and lymphocytes would be potent assistant indicators for the early diagnosis of pertussis in young children.
H.F.Z and K.Y.L conceptualized and drafted the initial manuscript. H.Q.L and X.M.Z. collected the data and reviewed the manuscript. X.Y.R and X.Y. provided patient samples and clinical information, and reviewed the manuscript. All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.
This study protocol was approved by the hospital's committee on human research. The patient's parents provided written informed consent.
Eingereicht: 22. Januar 2020
Angenommen: 30. April 2020
10. Juni 2020 (online)
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- 1 Hewlett EL, Edwards KM. Clinical practice. Pertussis--not just for kids. N Engl J Med 2005; 352 (12) 1215-1222
- 2 Klein NP, Bartlett J, Rowhani-Rahbar A, Fireman B, Baxter R. Waning protection after fifth dose of acellular pertussis vaccine in children. N Engl J Med 2012; 367 (11) 1012-1019
- 3 Nguyen VTN, Simon L. Pertussis: the whooping cough. Prim Care 2018; 45 (03) 423-431
- 4 Cherry JD, Tan T, Wirsing von König CH. et al. Clinical definitions of pertussis: Summary of a Global Pertussis Initiative roundtable meeting, February 2011. Clin Infect Dis 2012; 54 (12) 1756-1764
- 5 Pandey S, Cetin N. Peripheral smear clues for Bordetella pertussis. Blood 2013; 122 (25) 4012
- 6 Funaki T, Miyairi I. Lymphocytosis in a baby with pertussis. Lancet Infect Dis 2015; 15 (01) 130
- 7 Rieu JB, Vergez F. Marked lymphocytosis and atypical cells with a cleft nucleus in a 1-month-old child. Blood 2019; 134 (02) 216
- 8 Meng QH, Shi W, Li LJ, Yao KH. “Cleaved lymphocytes” could be induced by pertussis toxin injection in mice, and are actually not lymphocytes. Clin Infect Dis 2018; 66 (04) 639-640
- 9 Di Matola T, Miele C, Coppola M. et al. Utility of peripheral blood smear in rapid diagnosis of pertussis. Int J Lab Hematol 2019; 41 (02) e41-e42
- 10 Chong CY, Yung CF, Tan NW, Acharyya S, Thoon KC. Risk factors of ICU or high dependency requirements amongst hospitalized pediatric pertussis cases: a 10 year retrospective series, Singapore. Vaccine 2017; 35 (47) 6422-6428
- 11 Daniels HL, Sabella C. Bordetella pertussis (pertussis). Pediatr Rev 2018; 39 (05) 247-257