Assessment of weight and height of patients with primary immunodeficiency disorders and group of children with recurrent respiratory tract infections

Abstract

Background: Primary immunodeficiences (PIDs) are a group of chronic, serious disorders in which the immune response is insufficient. In consequence, it leads to an increased susceptibility to infections. Up to date, there are about 350 different disorders classified in that group. There are also patients suffering from recurrent respiratory tract infections (RRTI), however that group doesn't present any abnormalities in terms of conducted immunological tests. Many factors, including medical, can have an impact on physical development of a child. Data such as birth weight and length, also weight, height, BMI during admission to the hospital were collected from 195 patients' medical histories from their hospitalization at Clinical Immunology and Paediatrics Ward of J. Gromkowski Hospital in Wrocław. Investigated groups included patients with PIDs, RRTI and a control group of healthy children. Our purpose was to evaluate the physical growth of children with PID and children with RRTI by assessment of their height and weight. All of parameters were evaluated using centile charts, suitable best for the Polish population.

Results: The lowest mean birth weight and height was found among the PIDs patients group. Children with PIDs during hospitalization had statistically relevant lower mean weight than the control group and almost 18% of them had their height situated below 3rd percentile. The statistically relevant differences have been found between them and RRTI group in terms of weight, height and nutritional status. The statistically significant difference was detected between the nutritional status of PID and control group.

Conclusions: There is a higher percentage of PID patients with physical growth abnormalities in comparison to healthy children. Our findings indicate a need for further investigation of immune system irregularities and their influence on physical growth of children.

Keywords: Growth assessment; Physical growth; Primary immunodeficiency; Recurrent respiratory tract infections.

Fig. 1

Birth weight and length analysis results as mean values ± standard deviations, PID divided into group with immunoglobulin substitution (PID Ig+therapy) and without (PID Ig-therapy). *-p < 0.05; ** -p <0.01; ***-p < 0.001

Fig. 2

Centiles percent distribution of certain patients groups actual weights, according to Polish standards. A significant statistical difference was found between weight centiles of children with PID and control group (p = 0,003) and between PID and RRTI group (p = 0,013)

Fig. 3

Centiles percent distribution of certain patients groups height, according to Polish standards. There was a statistically significant difference between height assigned to certain centiles of PID and RRTI group (p = 0,031)

Fig. 4

Z-score values of height of the PID, RRTI and control group patients. There were no statistically significant differences between PID and RRTI group (p = 0,362) or PID and control group (p = 0,1) in terms of height Z-score

Fig. 5

Nutritional status of participants aged 3-18 years old divided into groups. The statistically significant differences were detected between the nutritional status of PID patients and RRTI group (p = 0,023), as well as PID and control group (p = 0,016)

Fig. 6

BMIs Z-score of the PID, RRTI and control group. There was no statistically relevant difference in z-score BMI between PID and control group (p = 0,307), as well as between PID and RRTI (p = 0,1)

Fig. 7

Nutritional status of PID patients group divided into Ig+therapy and Ig-therapy groups