Viability Changes in Leucocytes in a Critical Trauma Patient: Monocyte, Lymphocyte, Granulocyte Response to the Acute Phase: Case Report

Trauma affects the activity of the innate immune system. The objective of this case report is to present the case that prompted us to analyse all the peripheral white blood cell lines. A 19 year old male patient was admitted to the Intensive Care Clinic with severe head trauma. The final diagnosis was set to be severe cerebral trauma with subarachnoid hemorrhage, right frontal and temporal cerebral contusions, diffuse cerebral edema, left parietal and temporal fracture, sphenoid hemosinus and right sided lung contusions.

Material and Method: Whole blood was immediatly analyzed by flow cytometry for leukocytes. Apoptosis was detected with Annexin V, necrotic cells were stained with propidium iodide. Samples were drawn three consecutive days.

Results: Lymphocytes, monocytes and granulocytes all showed marked increase in viability and decrease in necrosis during the biological monitoring in correlation with a positive clinical outcome. The most important changes were noted in the monocyte population.

Discussion: Although we started out monitoring neutrophil viability and death, this particular case prompted us not to overlook other leucocyte populations.

Conclusion: The apparent positive relationship between this patient’s positive clinical outcome and cellular viability and death changes is promising but they warrant further study.