Patient's child, 10 years old, complained of high fever with abdominal pain and was admitted to the hospital for 4 days.

Admission physical examination: Acute appearance, body temperature 38.5 ℃, rapid breathing, palpable enlarged lymph nodes on both sides of the neck, armpits, and groin, measuring 1.0 × 1.5 cm in size, soft in texture, with tenderness, and moderate mobility; Splenomegaly, about 2 cm below the ribs, soft texture without tenderness, and no obvious positive signs. Blood routine showed Hb 135 g/L, WBC 19.6 × 109/L, LYM: 78%, PLT 142 × 109/L.

After admission, complete bone marrow smear, flow cytometry and other examinations.(Click on to view complete and detailed medical history, past medical history, and family history information)

The smear results are as follows:Bone marrow hyperplasia is active, the proportion of primitive cells is poor, the proportion of granulocytes is reduced, and the proportion of lymphocytes is increased, with about 14.5% of lymphocytes visible (Figure 1).

Figure 1 Alien lymphocytes

The flow results are as follows:No obvious abnormal primitive cells were observed, the relative proportion of granulocytes decreased, the relative proportion of lymphocytes increased, and the CD4 to CD8 ratio of T cells decreased (0.21). CD8 positive T cells were divided into two groups: one group had weaker CD3 and CD8 (while CD7 was weakened, CD2 and CD5 could also be weakened to some extent), and the other group had stronger CD3 and CD8 (Figure 2).

Figure 2 T cell immune phenotype

Meanwhile, the EBV DNA quantification of the patient was 3.4 × 109/mL, and the EBV IgM antibody was positive.

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Pregnancy is a complex physiological process. From an immunological perspective, fetuses and their appendages with paternal antigens are similar to semi allogeneic transplants, which will lead to immune recognition and response by the maternal immune system. From the perspective of pregnancy outcomes, unlike transplantation, there is a certain change in the mother's immune response to the fetus, which prevents the fetus from being rejected.

So far, the mechanism of pregnancy and childbirth process is still unclear But it can be confirmed that immune cells and reactions play an important role in it. How does the overall immune function status of the body change during pregnancy, and which group of cells are important for monitoring pregnancy and recurrent miscarriage?

Author: Cheng Yingwen

Dr. Zhou Jianfeng

Medical Director of Hematology at Jinyu Medical Marketing and Operations Center

-Clinical Medical English Class of Shandong University School of Medicine, Bachelor of Medicine from 2002 to 2008.

-From 2008 to 2013, I obtained my Ph.D. in Clinical Medicine (Hematology in Internal Medicine) at Tianjin Hematology Hospital of Peking Union Medical College. I studied under Professor Zhu Xiaofan, a renowned pediatric hematology specialist in China, and completed rotations in the Department of Internal Medicine and Hematology during my graduate studies. I have a solid foundation in these fields and have participated in natural genetics and technology climbing projects. I have published several articles in various domestic and international journals.

-Joined Jin Yu Medical in 2013, mainly responsible for blood pathology diagnosis, particularly skilled in blood tumor immune typing detection, minimal residual disease flow cytometry detection, and molecular diagnosis of blood diseases.

Editor in Chief: Hang Lu

Image source: Station Cool Hailuo

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