Adenosine deaminase activity in protein-energy malnutrition

Cell-mediated immunity (CMI) was evaluated in 69 children with protein-energy malnutrition (PEM) and 20 healthy controls. Significantly decreased responses to purified protein derivative (PPD) (p < 0.02) and absolute lymphocyte count (ALC) (p < 0.01) and increased serum adenosine deaminase (ADA) activity (p < 0.001) were observed in PEM cases compared with the controls. The mean values of ALC and ADA activity in PEM patients were 85.9% and 158.7% of the normal mean, respectively. A significant negative correlation was observed between the two parameters (r=- 0.2765, p < 0.01). The CMI tests were abnormal in all three grades of PEM, except for the response to PPD in grade I, when compared with the controls. No significant differences were found between infected and uninfected PEM cases. Thus, impaired CMI was observed not only in grades II and III but also in grade I PEM patients and the concomitant infection did not affect its status. However, ADA activity demonstrated a more pronounced change than the other tests.