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The relationship between preoperative serum immunoglobulin levels and the development of bacteremia after tonsillectomy

Year 2004, Volume: 12 Issue: 1, 31 - 34, 15.03.2004

Abstract

Objectives: We examined the risk tor the develop­ ment of bacteremia during tonsillectomy and evaluated the presence of an association between bacteremia and preoperative serum immunoglobulin levels.Patients and Methods: The study included 40 patients 16 males, 24 females; mean age 16.8 years; range 5 to 35 years who undervvent tonsillectomy with the useofthedissection-sneartechnique. Preoperatively, venous blood samples were collected from ali the patients to determine serum immunoglobulin levels and the presence or absence of bacteremia. Bacteremia was also investigated in blood samples postoperatively.Results: There was no growth in the preoperative blood cultures, but bacteremia was documented in 10 patients 25% after tonsillectomy. Increased serum IgG levels were determined in 15 patients before operation, seven of whom developed bac­ teremia after tonsillectomy p<0.05 . There was no correlation between postoperative bacteremia and preoperative serum IgM or IgA levels p>0.05 .Conclusion: Although our current knowledge does not allow to predict bacteremia following tonsillectomy in advance, the finding that seven of 10 patients who devel­ oped bacteremia had increased preoperative IgG levels draws attention to serum IgG, especially in patents in whom bacteremia may present additional risks.

References

  • Brandtzaeg P. Mucosal immunity IgA and polymor- phonuclear neutrophils. In: Revillar JP, Viosin C, Wierzbicki N, editors. The human secretory immune system: general rewiew. 2nd ed. Paris: Foundation Franco Allemande Suresnes; 1985. p. 13-43.
  • Surjan L Jr. Tonsils and lympho-epithelial structures in the pharynx as immuno-barriers. Acta Otolaryngol 1987;103:369-72.
  • Bock A, Popp W, Herkner KR. Tonsillectomy and the immune system: a long-term follow up comparison between tonsillectomized and non-tonsillectomized children. Eur Arch Otorhinolaryngol 1994;251:423-7.
  • Bussi M, Carlevato MT, Galeazzi E, Morra B. Immunological investigations on tonsillar and periph- eral blood lymphocytes after adeno-tonsillectomy. Possible suggestions for phenotypical and functional differences. Acta Otolaryngol 1991;111:379-83.
  • Carithers JS, Gebhart DE, Williams JA. Postoperative risks of pediatric tonsilloadenoidectomy. Laryngoscope 1987;97:422-9.
  • Rasmussen N. Complications of tonsillectomy and adenoidectomy. Otolaryngol Clin North Am 1987;20: 383-90.
  • Wong VK, Wright HT Jr. Group A beta-hemolytic streptococci as a cause of bacteremia in children. Am J Dis Child 1988;142:831-3.
  • Francois M, Bingen EH, Lambert-Zechovsky NY, Mariani-Kurkdjian P, Nottet JB, Narcy P. Bacteremia during tonsillectomy. Arch Otolaryngol Head Neck Surg 1992;118:1229-31.
  • Kaygusuz I, Gok U, Yalcin S, Keles E, Kizirgil A, Demirbag E. Bacteremia during tonsillectomy. Int J Pediatr Otorhinolaryngol 2001;58:69-73.
  • Döner F, Yorgacıgil B, Doğru H, Gedikli O, Yarıktaş M. Tonsillektomi esnasında bakteriyemi riski. KBB Baş Boyun Cerrahisi Dergisi 1996;3:254-257.
  • Kornblut AD. A traditional approach to surgery of the tonsils and adenoids. Otolaryngol Clin North Am 1987;20:349-63.
  • King RC, Crawford JJ, Small EW. Bacteremia following intraoral suture removal. Oral Surg Oral Med Oral Pathol 1988;65:23-8.
  • Lal H, Sachdeva OP, Mehta HR. Serum immunoglobu- lins in patients with chronic tonsillitis. J Laryngol Otol 1984;98:1213-6.
  • Zannino L, Nebiolo F, Rovere A, Ronco F, Bisi O, Weisz G. Study of serum immunoglobulin levels (IgG, IgA, IgM) in a population of children undergoing adenoton- sillectomy. Minerva Pediatr 1983;35:225-9. [Abstract]
  • Tekin M, Osma Ü, Üstel M, Meriç F, Oktay F, Turgut C ve ark. Tonsillektominin serum immünglobulinleri üzerine etkisi. Kulak Burun Bogaz Ihtis Derg 1999; 6:43-5.
  • Brook I, Foote PA Jr. Comparison of the microbiology of recurrent tonsillitis between children and adults. Laryngoscope 1986;96:1385-8.
  • Gürsan Ö, Bülbül T. Tonsillektomi ve serum IgA ile sekretuar IgA arasındaki ilişkiler. Türk ORL Arşivi 1991;29:140-1.

Ameliyat öncesindeki serum immünglobülin düzeyleri ile tonsillektomi sonrasında bakteriyemi gelişmesi arasındaki ilişki

Year 2004, Volume: 12 Issue: 1, 31 - 34, 15.03.2004

Abstract

Amaç: Tonsillektomi sırasında bakteriyemi gelişimriskini gözden geçirmek ve bakteriyemi ile ameliyatöncesi serum immünglobülin düzeylerinin olası bağlantısını değerlendirmek.Hastalar ve Yöntemler: Çalışmaya tonsillektomi endikasyonu konan ve snear diseksiyon tekniği yoluylatonsillektomi uygulanan 40 hasta 16 erkek, 24 kadın;ort. yaş 16.8; dağılım 5-35 years alındı. Tüm hastalardan ameliyat öncesinde alınan venöz kan örneklerinde serum immünglobülin düzeyleri araştırıldı ve kültürsonuçları değerlendirildi. Ameliyat sonrası alınan örneklerde bakteriyemi varlığı araştırıldı.Bulgular: Ameliyat öncesindeki kan kültürlerinin hiçbirinde üreme olmamasına karşın, tonsillektomi sonrasında kan örneklerinin %25’inde bakteriyemi saptandı.Serum IgG düzeyinin ameliyat öncesinde 15 hastadayüksek olduğu belirlendi; bu hastaların yedisinde tonsillektomi sonrasında bakteriyemi gelişti p0.05 .Sonuç: Bugünkü bilgilerimize göre, tonsillektomi ameliyatı sonrasında gelişen bakteriyemiyi ameliyat öncesinde belirlemek mümkün olmasa da, bakteriyemi gelişen10 hastanın yedisinde serum IgG düzeyinin yüksek bulunması, özellikle bakteriyeminin ek risk oluşturacağıhastalarda dikkati IgG’ye çekmektedir

References

  • Brandtzaeg P. Mucosal immunity IgA and polymor- phonuclear neutrophils. In: Revillar JP, Viosin C, Wierzbicki N, editors. The human secretory immune system: general rewiew. 2nd ed. Paris: Foundation Franco Allemande Suresnes; 1985. p. 13-43.
  • Surjan L Jr. Tonsils and lympho-epithelial structures in the pharynx as immuno-barriers. Acta Otolaryngol 1987;103:369-72.
  • Bock A, Popp W, Herkner KR. Tonsillectomy and the immune system: a long-term follow up comparison between tonsillectomized and non-tonsillectomized children. Eur Arch Otorhinolaryngol 1994;251:423-7.
  • Bussi M, Carlevato MT, Galeazzi E, Morra B. Immunological investigations on tonsillar and periph- eral blood lymphocytes after adeno-tonsillectomy. Possible suggestions for phenotypical and functional differences. Acta Otolaryngol 1991;111:379-83.
  • Carithers JS, Gebhart DE, Williams JA. Postoperative risks of pediatric tonsilloadenoidectomy. Laryngoscope 1987;97:422-9.
  • Rasmussen N. Complications of tonsillectomy and adenoidectomy. Otolaryngol Clin North Am 1987;20: 383-90.
  • Wong VK, Wright HT Jr. Group A beta-hemolytic streptococci as a cause of bacteremia in children. Am J Dis Child 1988;142:831-3.
  • Francois M, Bingen EH, Lambert-Zechovsky NY, Mariani-Kurkdjian P, Nottet JB, Narcy P. Bacteremia during tonsillectomy. Arch Otolaryngol Head Neck Surg 1992;118:1229-31.
  • Kaygusuz I, Gok U, Yalcin S, Keles E, Kizirgil A, Demirbag E. Bacteremia during tonsillectomy. Int J Pediatr Otorhinolaryngol 2001;58:69-73.
  • Döner F, Yorgacıgil B, Doğru H, Gedikli O, Yarıktaş M. Tonsillektomi esnasında bakteriyemi riski. KBB Baş Boyun Cerrahisi Dergisi 1996;3:254-257.
  • Kornblut AD. A traditional approach to surgery of the tonsils and adenoids. Otolaryngol Clin North Am 1987;20:349-63.
  • King RC, Crawford JJ, Small EW. Bacteremia following intraoral suture removal. Oral Surg Oral Med Oral Pathol 1988;65:23-8.
  • Lal H, Sachdeva OP, Mehta HR. Serum immunoglobu- lins in patients with chronic tonsillitis. J Laryngol Otol 1984;98:1213-6.
  • Zannino L, Nebiolo F, Rovere A, Ronco F, Bisi O, Weisz G. Study of serum immunoglobulin levels (IgG, IgA, IgM) in a population of children undergoing adenoton- sillectomy. Minerva Pediatr 1983;35:225-9. [Abstract]
  • Tekin M, Osma Ü, Üstel M, Meriç F, Oktay F, Turgut C ve ark. Tonsillektominin serum immünglobulinleri üzerine etkisi. Kulak Burun Bogaz Ihtis Derg 1999; 6:43-5.
  • Brook I, Foote PA Jr. Comparison of the microbiology of recurrent tonsillitis between children and adults. Laryngoscope 1986;96:1385-8.
  • Gürsan Ö, Bülbül T. Tonsillektomi ve serum IgA ile sekretuar IgA arasındaki ilişkiler. Türk ORL Arşivi 1991;29:140-1.
There are 17 citations in total.

Details

Primary Language English
Journal Section Research Article
Authors

Erol Keleş This is me

Üzeyir Gök This is me

Hayrettin Cengiz Alpay This is me

Murat Aral This is me

Publication Date March 15, 2004
Published in Issue Year 2004 Volume: 12 Issue: 1

Cite

APA Keleş, E., Gök, Ü., Alpay, H. C., Aral, M. (2004). The relationship between preoperative serum immunoglobulin levels and the development of bacteremia after tonsillectomy. The Turkish Journal of Ear Nose and Throat, 12(1), 31-34.
AMA Keleş E, Gök Ü, Alpay HC, Aral M. The relationship between preoperative serum immunoglobulin levels and the development of bacteremia after tonsillectomy. Tr-ENT. March 2004;12(1):31-34.
Chicago Keleş, Erol, Üzeyir Gök, Hayrettin Cengiz Alpay, and Murat Aral. “The Relationship Between Preoperative Serum Immunoglobulin Levels and the Development of Bacteremia After Tonsillectomy”. The Turkish Journal of Ear Nose and Throat 12, no. 1 (March 2004): 31-34.
EndNote Keleş E, Gök Ü, Alpay HC, Aral M (March 1, 2004) The relationship between preoperative serum immunoglobulin levels and the development of bacteremia after tonsillectomy. The Turkish Journal of Ear Nose and Throat 12 1 31–34.
IEEE E. Keleş, Ü. Gök, H. C. Alpay, and M. Aral, “The relationship between preoperative serum immunoglobulin levels and the development of bacteremia after tonsillectomy”, Tr-ENT, vol. 12, no. 1, pp. 31–34, 2004.
ISNAD Keleş, Erol et al. “The Relationship Between Preoperative Serum Immunoglobulin Levels and the Development of Bacteremia After Tonsillectomy”. The Turkish Journal of Ear Nose and Throat 12/1 (March 2004), 31-34.
JAMA Keleş E, Gök Ü, Alpay HC, Aral M. The relationship between preoperative serum immunoglobulin levels and the development of bacteremia after tonsillectomy. Tr-ENT. 2004;12:31–34.
MLA Keleş, Erol et al. “The Relationship Between Preoperative Serum Immunoglobulin Levels and the Development of Bacteremia After Tonsillectomy”. The Turkish Journal of Ear Nose and Throat, vol. 12, no. 1, 2004, pp. 31-34.
Vancouver Keleş E, Gök Ü, Alpay HC, Aral M. The relationship between preoperative serum immunoglobulin levels and the development of bacteremia after tonsillectomy. Tr-ENT. 2004;12(1):31-4.