Delayed hypersensitivity and levels of serum transferrin in burn patients and their clinical significance

Skin testing with three recall antigens was performed serially in 50 burn patients（mean size of burn was 26.4%,Ⅲ°burn 10.5%）.In anergic patients the incidence of sepsis was 50%.and the mortality was 33%,while in relative anergic patients it was 22.2%,without any death. Neither sepsis nor death ocurred in normal skin testing patient（P＜0.001）.The levels of serum transferrin in these patients were examined simultaneously.The incidences of sepsis in burn patients whose levels of serum transferrin were lower and higher than 250mg/dl were 35% and 3.3% respectively,and the mortality in the fomer group was 20%,and that in the latter was zero（P＜0.001）.The levels of serum transferrin were 192.5±47.2mg/dl in anergic patients, 237.5±25.1mg/dl in relative anergic patients and 304.6±45.3 mg/dl in patients with normal reactivily（P＜0.01）,As the restoration of levels of serum transferrin occurred,the skin testing changed from anergy to normal.These results suggest that both delayed hypersensitivity and levels of serum transferrin are indexes for prognosis available in burn patients.Moreover,incidences of sepsis and mortality may decline after sufficient nutritios given.