The size of thymus and its correlates between children admit
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In resource-limited environments, malnutrition remains a major cause of mortality and morbidity among children. Extreme thymus atrophy is encountered by children with severe acute malnutrition (SAM), likely representing poor immune function. The extreme infections they undergo that lead to mortality are responsible for this immune dysfunction.

Knowing the thymus size associations may help clinicians distinguish those who may have more serious immune deficiency or more severe atrophy. Researchers aimed to identify thymus size and its correlates at admission among children hospitalised with SAM.

This cross-sectional study involved children who were 6-59 months old with complicated SAM. Well-nourished children from same communities were used as a community reference group for thymus size. At admission, thymus size was measured by ultrasound scan. Demographic, clinical and laboratory variables were identified at admission. A linear regression model was used to determine correlates of thymus size among children with SAM.

Results:
Among 388 children with SAM, the mean age was 17±8.5 months and 58% were boys.
--The mean thymus size was 3.14 cm2 lower than that of the 27 healthy community reference children (1.06 vs 4.2 cm2) when controlled for age.
--Thymus size positively correlated with current breastfeeding (0.14), anthropometric measurements at admission (weight, length, mid-upper-arm circumference, weight-for-height Z scores and length-for-age Z scores) and suspected tuberculosis (0.12).
--Thymus size negatively correlated with more than 2 weeks duration of sickness (-0.10).

In fact, the thymus is a nutrition barometer since both anthropometric measurements and breastfeeding have been correlated with larger thymus. The immune benefits of breastfeeding are underlined in children with SAM. A smaller thymus gland was observed in children with a longer period of illness, suggesting that infections play a part in the cause or effect of thymus atrophy.

Source: https://bmcpediatr.biomedcentral.com/articles/10.1186/s12887-020-02457-3
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