PD251 - INFECTION MODULATES EARLY LYMPHOCYTE DYNAMICS IN PATIENTS WITH CHYLOUS FISTULA RECEIVING PARENTERAL NUTRITION

PD251

INFECTION MODULATES EARLY LYMPHOCYTE DYNAMICS IN PATIENTS WITH CHYLOUS FISTULA RECEIVING PARENTERAL NUTRITION

A. P. P. Masa^1,*, T. D. R. Hortencio¹, M. G. B. Vieira¹, M. D. Calepso¹, R. J. N. Nogueira¹

¹UNICAMP, CAMPINAS , Brazil

Rationale: The lymphatic system is essential for immunity; chylous fistulae cause secondary immunodeficiency due to the massive loss of lymphocytes in the chyle. This study is justified by the need to monitor this cellular depletion and evaluate whether the reduction in lymphocyte counts within 48 hours correlates with the occurrence of infectious processes.

Methods: This retrospective descriptive study analysed secondary data from the Multidisciplinary Nutritional Therapy Team (EMTN) at the HC-UNICAMP (2018–2024). Absolute leukocyte and lymphocyte counts (cells/µL) were analysed at  PN onset and after 48h, with lymphopenia (<1,500cells/µL), severe lymphopenia (<500cells/µL), and relative lymphopenia (<20% lymphocyte count) being classified¹. Additionally, the occurrence of infections and the time interval between fistula diagnosis and the infectious event were recorded. The study was approved by the Ethics Research Committee (CAAE: 86206224.9.0000.5404).

Results: A total of 22 patients with chylous fistula receiving parenteral nutrition were included. In the overall cohort. The patients with infection exhibited a more pronounced decline in lymphocyte counts over 48 hours compared to those without infection. In fact, they had a reduction in both absolute (p=0.04) and relative (p=0.03) lymphocyte counts, whereas those without infection demonstrated relative stability or a slight increase over time.

Conclusion: In patients with chylous fistula receiving PN, stratified by infection status, patients with infection exhibited a significantly greater decline in lymphocyte counts compared to those without infection. These findings suggest that lymphopenia in this population is not solely attributable to mechanical lymphatic loss, supporting the role of infection as a relevant biological modifier of lymphocyte dynamics. In contrast, total leukocyte counts did not differ significantly between groups over time.

Disclosure of Interest: None declared