Abstract：Objective To study the value of cleaved lymphocytes in peripheral blood smear in assisting the early diagnosis of pertussis. Methods Nasopharyngeal swabs and peripheral blood samples were collected from 107 children with pertussis-like disease. PCR-flow fluorescent hybridization was used to detect the nucleic acids of Bordetella pertussis. Based on the detection results, the children were divided into two groups:pertussis (n=52) and non-pertussis (n=55). According to age, the pertussis group was divided into two subgroups:<1 year old (n=42) and ≥ 1 year old (n=10). According to disease severity, the pertussis group was divided into another two subgroups:mild (n=45) and severe (n=7). An automatic blood cell analyzer was used to determine peripheral blood cell counts. Wright's staining and peroxidase staining were used to observe and count cleaved lymphocytes under a microscope. Results Cleaved lymphocytes in peripheral blood were round with small cytoplast, less cytoplasm and cleaved or lobulated nuclei. According to the negative peroxidase staining results, these cells were confirmed as lymphocytes. Compared with the non-pertussis group, the pertussis group had significantly higher leukocyte count, lymphocyte percentage, platelet count, and percentage of cleaved lymphocytes (P < 0.001). For the children with pertussis, the <1 year old subgroup had significantly higher lymphocyte percentage, platelet count, and percentage of cleaved lymphocytes than the ≥ 1 year old subgroup (P < 0.05). The severe subgroup had slightly higher leukocyte count, lymphocyte percentage, platelet count, and percentage of cleaved lymphocytes than the mild subgroup (P > 0.05). Conclusions The detection of cleaved lymphocytes combined with peripheral blood cell counts provides a new option for the early diagnosis of pertussis in children.
XU Xiu-Zhuang,ZHANG Jin-Can. Clinical value of cleaved lymphocytes in assisting the diagnosis of pertussis in children[J]. CJCP, 2020, 22(9): 996-1000.
Tong J, Buikema A, Horstman T. Epidemiology and disease burden of pertussis in the United States among individuals aged 0-64 over a 10-year period (2006-2015)[J]. Curr Med Res Opin, 2020, 36(1):127-137.
[2]
Hartzell JD, Blaylock JM. Whooping cough in 2014 and beyond:an update and review[J]. Chest, 2014, 146(1):205-214.
[3]
Swamy GK, Wheeler SM. Neonatal pertussis, cocooning and maternal immunization[J]. Expert Rev Vaccines, 2014, 13(9):1107-1114.
[4]
Wu DX, Chen Q, Yao KH, et al. Pertussis detection in children with cough of any duration[J]. BMC Pediatr, 2019, 19(1):236.
Meng QH, Shi W, Li LJ, et al. "Cleaved Lymphocytes" could be induced by pertussis toxin injection in mice, and are actually not lymphocytes[J]. Clin Infect Dis, 2018, 66(4):639-640.
