1/11. Strong alpha beta and gamma delta TCR response in a patient with disseminated mycobacterium avium infection and lack of NK cells and monocytopenia.Infection with atypical mycobacteria occurs mainly in patients with a compromised cellular immune system, in particular in those with a defective T cell or monocyte function. Here we analyzed the specific immune response of an adolescent hiv-negative patient with disseminated mycobacterium avium infection and fatal varizella zoster virus infection. The patient presented with dysplastic hematopoesis of all cell lineage's and a bicytopenia of erythrocytes and leukocytes, but a hematological malignancy could not be found. We found a peripheral lymphopenia and monocytopenia, as well as a lack of NK-cells and B-cells. Lymphocytes consisted of 95% T cells, which contained up to 40% of TCR gammadelta CD4-CD8-T-cells (mainly TCR gamma9delta2), few monocytes and B-cells. Approximately 50% of CD3 T-cells showed a CD57 NK-like phenotype. Functional analysis of PBMC revealed a good antigen-specific T cell function if antigen-presenting cells were supplemented from a HLA-matched donor. Moreover, a strong M. avium specific cytotoxicity mediated by TCR alphabeta T-cells could be found in vitro and even ex vivo. In contrast, NK-killing was absent. No evidence for a defect in IL-12 or IFN-gamma production and signaling were found. The data indicate that a strong alphabeta and gammadelta T cell immunity tries to compensate for a deficient monocyte and NK cell function in this patient.- - - - - - - - - - ranking = 1keywords = leukocytes (Clic here for more details about this article) |
2/11. Reversible dysfunction of t-lymphocytes in common variable immunodeficiency.A 30-year-old man with recurrent sinopulmonary infections, eventually fatal, was found to have common variable immunodeficiency. In addition to low serum immunoglobulin concentrations he also had lymphopenia and cell-mediated immunodeficiency as shown by cutaneous anergy and a poor lymphocyte response to phytohemagglutinin (PHA) in vitro. However, intradermal injection of PHA produced a vigorous cutaneous response, showing that some cell-mediated responsiveness remained. The responsiveness of his lymphocytes to PHA was restored towards normal (confirmed by chromosome studies) by the addition of a small number of normal leukocytes to cultures; thus a reversible functional defect in his t-lymphocytes was revealed. Experiments indicated that the defect was cellular and not due to serum factors and it was concluded that normal leukocytes restored a missing factor to the patient's t-lymphocytes. Although counts of macrophage precursor cells in the bloodstream were low, thus contributing to the immunodeficiency, this could not have caused the reduced PHA response. Several relatives of this patient had lymphoma; two cousins had common variable immunodeficiency.- - - - - - - - - - ranking = 2keywords = leukocytes (Clic here for more details about this article) |
3/11. A 55-year-old man with hypogammaglobulinemia, lymphopenia, and unrelenting cutaneous warts.A 55-year-old white man with a history of hypertension, fibromyalgia, and colonic polyps presented with unrelenting plantar warts on his hands and feet for the past 4 years. He was otherwise healthy and without a history of recurrent infections. physical examination was unremarkable except for extensive warts on his hands and feet. Pertinent laboratory findings included hypoalbuminemia, hypogammaglobulinemia, and lymphopenia most severely affecting CD4( ) T cells. Testing for hiv infection was negative. This clinical and laboratory presentation suggested a combined humoral and cellular immunodeficiency syndrome that could be best explained by loss of lymphocytes, immunoglobulins, and other serum proteins. Additional immunologic testing revealed a marked reduction in peripheral blood naive (CD4( )CD45RA( )) T cells. A 24-hour stool collection showed a markedly elevated alpha(1)-antitrypsin level. These findings were most consistent with the diagnosis of intestinal lymphangiectasia, a type of protein-losing enteropathy associated with hypoalbuminemia, hypogammaglobulinemia, and lymphopenia, characterized by a preferential loss of naive CD4( ) T cells into the gastrointestinal tract. This case illustrates the importance of considering intestinal loss of immunoglobulins and lymphocytes in the differential diagnosis of the adult patient who presents with laboratory evidence of a combined humoral and cellular immunodeficiency. It also underscores the diagnostic utility of the clinical immunology laboratory and how flow cytometry, in particular, can contribute to an understanding of pathogenic mechanisms.- - - - - - - - - - ranking = 0.053124215549383keywords = white (Clic here for more details about this article) |
4/11. Acquired T cell specific deficiency other than acquired immunodeficiency syndrome (AIDS).Evidence of an acquired T cell-specific deficiency distinct from acquired immunodeficiency syndrome (AIDS) in a 63-yr-old Japanese female is provided. Recently, this patients suffered from primary invasive pulmonary aspergillosis. skin tests to purified protein derivative of tuberculin (PPD) and aspergillus antigens were negative. Upon admission to our hospital, her lymphocytes were exclusively unresponsive to T cell mitogens (concanavalin a, phytohemagglutinin, and OKT 3). The level of cells defined by monoclonal antibodies (CD1, CD2, CD3, CD4, WT31, and CD5) was less than 3%. In contrast, no decrease in the number of red blood cells, platelets, neutrophils or B cells was apparent. Five years ago, the patient had a normal white blood cell and lymphocyte count. However, over the following 4 yr, she developed lymphopenia. With medication, her pulmonary disease recovered, while lymphopenia still continued. The levels of immunoglobulins, complements and enzyme activities (adenosine deaminase and purine nucleoside phosphorylase) were normal. Moreover, several tests for hiv (ELISA and Western bolt) were negative suggesting that the T cell-specific deficiency was not a congenital immunodeficiency or AIDS but rather a new type of acquired immunodeficiency.- - - - - - - - - - ranking = 1.047403076286keywords = blood cell, white (Clic here for more details about this article) |
5/11. Squamous carcinoma of the anus in young homosexual men with T helper cell depletion.Two cases of squamous carcinoma of the anus in white homosexual men aged 36 and 47 years are reported, each with a short history of rapidly enlarging perianal lesions. Immunological studies showed that both men had pronounced T helper lymphocyte depletion, and antibody to human T cell lymphotropic virus type III (HTLV-III) was detected in both patients. In addition one patient had a long history of wart virus infection of the anal canal. The diminished cellular immunity associated with HTLV-III may have been responsible for the development of the squamous carcinoma, either directly or by its association with human papilloma virus infection.- - - - - - - - - - ranking = 0.053124215549383keywords = white (Clic here for more details about this article) |
6/11. Peripheral leukocytes in psoriasis.The white blood cell (WBC) count and differential count, including the morphology and acid alpha-naphthyl acetate esterase (ANAE) activity of lymphocytes, in psoriatic patients of different types, stages, and extensiveness of skin lesions were analyzed. The number of total WBC and polymorphonuclear leukocytes was markedly increased in psoriasis erythrodermica and psoriasis pustulosa. Lymphocytopenia, especially T-lymphocytopenia, was noticed in all types of psoriasis. Antineoplastic drugs and immunosuppressants intensified the degree of T-lymphocytopenia. This might be the cause of recurrence and more recalcitrant course of the disease. Therefore, it is considered that these drugs should not be the first choice in the treatment of psoriasis.- - - - - - - - - - ranking = 5.5502636459177keywords = leukocytes, blood cell, white (Clic here for more details about this article) |
7/11. Localized cutaneous cryptococcosis in an immunosuppressed man.Isolated cutaneous cryptococcosis developed in a 62-year-old white man with an idiopathic deficiency of t-lymphocytes. The patient was healthy, except for the cutaneous infection, and displayed no other evidence of an immunodeficiency disorder. An immunologic workup should be conducted in all patients with cryptococcal infection, regardless of their apparent health status.- - - - - - - - - - ranking = 0.053124215549383keywords = white (Clic here for more details about this article) |
8/11. M. Kansasii pulmonary disease in idiopathic CD4 T-lymphocytopenia.Cases of patients with markedly depressed CD4 T-lymphocyte counts, with or without opportunistic infections, in the absence of any evidence of human immunodeficiency virus (hiv) have been described in recent years. In 1992, the definition of "idiopathic CD4 T-lymphocytopenia" was formulated by the Centers for disease Control and Prevention (CDC) of Atlanta (USA). The present case illustrates the occurrence of an unexplained mycobacterium kansasii pneumonia in a white hiv-negative subject with a persistent depletion of CD4 t-lymphocytes and suppression of cell-mediated immunity. To our knowledge, this is the first observation of idiopathic CD4 T-lymphocytopenia with pulmonary mycobacteriosis due to mycobacterium kansasii, and the sixth case of this kind of immunodeficiency described in italy.- - - - - - - - - - ranking = 0.053124215549383keywords = white (Clic here for more details about this article) |
9/11. Lymphocytopenia and thrombocytopenia during treatment with risperidone or clozapine.The atypical antipsychotic clozapine is associated with several well-known abnormalities of blood cell count, whereas only rare reports are associated with the neuroleptic risperidone. This report describes lymphocytopenia and thrombocytopenia under treatment with risperidone which continued after changing to clozapine without other clinically significant abnormal hematological parameters. Within one week after discontinuation of both neuroleptics abnormalities of blood cell count reversed to the initial values. Abnormalities of lymphocytes or thrombocytes are rare side-effects under treatment with risperidone or clozapine.- - - - - - - - - - ranking = 0.99427886073662keywords = blood cell (Clic here for more details about this article) |
10/11. An unusual course of progressive multifocal leukoencephalopathy in a patient with idiopathic CD4 T lymphocytopenia.A case is reported of idiopathic CD4 T lymphocytopenia with progressive multifocal leukoencephalopathy and cervical lymph node tuberculosis. A 57 year old Japanese man presented with cervical lymphadenopathy and progressive neurological deficits, and six months later he developed akinetic mutism. He had a persistent severely depressed number of circulating CD4 T lymphocytes in the absence of human immunodeficiency virus infection. T1 weighted MRI showed a diffuse decreased signal intensity limited to the white matter without mass effect. A brain biopsy specimen had a morphology similar to that of progressive multifocal leukoencephalopathy. polyomavirus antigen was detected in the brain lesion, and viral dna was identified in nucleated blood cells and urine. Unusually this serious medical condition has lasted for more than three years without remission. To our knowledge this is the first patient with CD4 T lymphocytopenia with progressive multifocal leukoencephalopathy, suggesting that similar opportunistic infections should be considered even in previously normal people.- - - - - - - - - - ranking = 0.55026364591769keywords = blood cell, white (Clic here for more details about this article) |
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