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ArticleIndian journal of pediatrics2026

Prognostic Significance of Immune Abnormalities in Children with Severe Sepsis.

Gargi Das, Muralidharan Jayashree, Amit Rawat, Aaqib Banday, Anju Gupta

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Article in Indian journal of pediatrics, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

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2citing papers in PubMed
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3 · Its place in the literature

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2 citing papers in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

5 authors.

Gargi DasDepartment of Pediatrics, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.
Muralidharan JayashreeDivision of Pediatric Emergency and Critical Care, Department of Pediatrics, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.
Amit RawatDivision of Pediatric Immunology and Rheumatology, Department of Pediatrics, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, 160012, India.
Aaqib BandayDivision of Pediatric Immunology and Rheumatology, Department of Pediatrics, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, 160012, India.
Anju GuptaDivision of Pediatric Immunology and Rheumatology, Department of Pediatrics, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, 160012, India. anjupgi@gmail.com.ORCID 0000-0003-3567-7209

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesTo evaluate the immunoglobulin levels and lymphocyte subsets in children with severe sepsis at admission to the pediatric intensive care unit (PICU) and correlate them to mortality.

methodsA prospective study was conducted on 52 children with severe sepsis/septic shock. Serum immunoglobulins and lymphocyte subsets were measured at diagnosis in all patients and after 3 mo in survivors. Regression analysis was used to identify factors associated with mortality.

resultsThe median (interquartile range, IQR) age was 5 (3-7.5) y, with 62% boys. The median (IQR) time to hospital admission was 7 (4-10) d. Common diagnoses were acute meningoencephalitis, pneumonia, and tropical fever. At admission, the most common immune abnormality was low Natural killer (NK)-cell count (92%), followed by low T-cells (40%) and B-cells (36%). Among immunoglobulins, elevated IgM (27%) was most frequent, while low IgG (17%) and IgA (13%) were seen in a smaller subset. In this cohort, 19 (37%) children died due to severe sepsis. Low IgG was an independent predictor of mortality (OR: 2.77; 95% CI: 1.22-6.28; p = 0.014), irrespective of other immune abnormalities, time to presentation, gender, age at presentation, and illness severity score. At 3-mo follow-up, immune parameters normalized in most survivors, though some showed persistent lymphopenia (mostly low NK-cells), though all were clinically well.

conclusionsLow NK-cells, elevated IgM, and low T-/B-cells were common at admission in children with severe sepsis. Low IgG was an independent predictor of mortality. Most immune abnormalities were reversible at 3-mo follow-up.

Indexed as

ImmunoglobulinsLymphocyte SubsetsSepsisChildChild, PreschoolFemaleHumansIntensive Care Units, PediatricKiller Cells, NaturalMalePrognosisProspective StudiesImmunoglobulinsHypogammaglobulinemiaMortalityPediatricSevere sepsis

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.