Source: Annual Congress 2003 - Clinical features in tuberculosis - I
Disease area: Respiratory infections

Abstract

The syndrome of idiopathicCD4+ T lymphocytopenia (ICL) is an unusual immune defect and is characteised by persistent deficit of CD4+ T cell, leading to fungal, parasitic or other opportunistic infections. Reports indicate that in ICL patients the peripheral blood CD4+ T cells is below or =250 cell/mm3 or less than 20% of the total lymphocytes in the absent of either HIV infection or other known causes of immunodeficiency. The purpose of this study was to report the first case of (to our knowledge) an ICL in a 45-year-old man with extra pul monary tuberculosis and smear positive for aspergillus fumigatus and with IgE level of 385 mIU/ml. Dual colour flow cytometric analysis on peripheral blood lymphocytes were performed in two different centres and patient followed for six months and still is under observartion. The results obtained (% mean values) are as follows: CD2+=80.9; CD3+=85; CD19+=17; CD3+/CD4+=5.5; CD3+/CD8+=78.6; CD4/CD8=0.02; CD3+/HLA-DR+=50; CD16+56=1; CD3+/CD16+56=35.5; CD69+=1; CD3+/CD95+=36; CD3+/CD25+=1.5; CD4+/CD25+=0.0; CD4+/CD95+=5; CD8+/CD28+=3.5; CD57+/CD8+=10; CD57-/CD8+=73; CD57+/CD8-=17; CD3+/TCRγδ+=0.0 and Th1/Th2 ratio was 1.2. Moreover, CD119 expression was normal when compared to a normal subject. Intriguingly, in this patient with ICL there has been a tendency towards a decrease in percentages of NK cells with concomitant increase in the percentages of CD3+/CD16+56 cells. His CD4 counts rose from 2% to 12% after antibiotic therapy.

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S. Shahgasempour (Tehran, Iran). Idiopathic CD4+ T lymphocytopenia with disseminated extra pulmonary tuberculosis with no evidence of HIV-1/2, HTLV-1/2 and HPV infection. A case report. Eur Respir J 2003; 22: Suppl. 45, 1005

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