1/5. CD4 T lymphocytopenia with disseminated HPV.BACKGROUND: There have been several reports of HIV-negative patients with chronic idiopathic CD4 T lymphocytopenia, the diagnostic criteria for which are: depressed numbers of circulating T lymphocytes (less than 300/ micro l or less than 20%) on more than one occasion; no laboratory evidence of hiv-1 or hiv-2 infection; and the absence of any defined immunodeficiency or therapy associated with depressed levels of CD4 T lymphocytes. methods: We report a patient with disseminated human papillomavirus infection associated with idiopathic CD4 T-cell lymphocytopenia. A 50-year-old woman presented to the dermatology clinic with a 10-year history of widespread verrucae involving the skin and the cervix. RESULTS: biopsy from the arm revealed a common wart. PCR analysis performed from the paraffin-embedded block was strongly positive for HPV type 2. Other HPV types (including EV-associated HPV 5, 8, 14, 15, 17) were not found. Further laboratory work up revealed T-cell lymphocytopenia, with an absolute CD4 count of 21. HIV tests were repeatedly negative. She was treated with interferon A 8 million units SQ three times per week with partial improvement. The patient underwent a hysterectomy for cervical dysplasia and a vulvectomy for vulvar intraepithelial neoplasia. She developed small-cell lung carcinoma and died. CONCLUSIONS: The diagnosis of idiopathic CD4 T-cell lymphocytopenia should be considered in any patient with widespread viral, fungal, or mycobacterial infection whose HIV test is negative, and appropriate evaluation of the absolute CD4 counts should be performed.- - - - - - - - - - ranking = 1keywords = intraepithelial, carcinoma (Clic here for more details about this article) |
2/5. Idiopathic CD4 T-cell lymphocytopenia with verrucae, basal cell carcinomas, and chronic tinea corporis infection.Idiopathic CD4 T lymphocytopenia should be considered in HIV-negative patients with skin lesions commonly associated with HIV infection. patients with idiopathic CD4 T lymphocytopenia are presumably rare, often have dermatologic lesions, always have low CD4 T lymphocyte counts, and lack all evidence of hiv-1 infection. We describe a young man with verrucae, basal cell carcinomas, chronic tinea corporis, and laboratory evidence supporting a diagnosis of idiopathic CD4 T lymphocytopenia.- - - - - - - - - - ranking = 0.04657193207595keywords = carcinoma (Clic here for more details about this article) |
3/5. Suspected idiopathic CD4 T-lymphocytopenia in a young patient with vulvar carcinoma stage IV.A case of a woman having a large invasive vulvar carcinoma is reported. Because of the early age of onset and recurrent pneumonia, immunodeficiency was suspected. There appeared to be a repetitive low CD4 T-lymphocyte count, without evidence of HIV infection or other diseases or therapies known to be clearly associated with T-cell depletion. This is suspected for the rare disorder known as idiopathic CD4 T-lymphocytopenia which is often associated with opportunistic infections. A case of suspected idiopathic CD4 T-lymphocytopenia in a patient having an invasive vulvar carcinoma is described.- - - - - - - - - - ranking = 0.05588631849114keywords = carcinoma (Clic here for more details about this article) |
4/5. Idiopathic CD4 T-lymphocytopenia and recurrent vulvar intraepithelial neoplasia.BACKGROUND: CD4 T-lymphocytopenia immunodeficiency without human immunodeficiency virus (HIV) infection has been reported recently. The association between immunodeficiency and anogenital neoplasia secondary to human papillomavirus infections is well documented. CASE: A woman with recurrent vulvar intraepithelial neoplasia (VIN) had idiopathic CD4 T-lymphocytopenia without HIV infection. CONCLUSION: Human papillomavirus-related VIN may be associated with idiopathic CD4 T-lymphocytopenia.- - - - - - - - - - ranking = 4.953428067924keywords = intraepithelial (Clic here for more details about this article) |
5/5. Active psoriasis and profound CD4 lymphocytopenia.We report the case of a patient with a long-standing history of widespread chronic plaque psoriasis, who was recently found to have a profound CD4 lymphocytopenia. He is human immunodeficiency virus (HIV) negative. His psoriasis remains active and widespread, and he has had 60 cutaneous malignancies, including many squamous cell carcinomas, excised over the last 10 years. In the past he has had numerous cutaneous viral warts. Despite a low peripheral blood CD4 T-cell count, similar numbers of activated T cells, identified by double labelling for CD4 and hla-dr antigens, were found in the epidermis of our patient as other individuals with psoriasis. Thus, there appear to be sufficient activated CD4 T cells in our patient's psoriatic plaques to maintain the psoriatic process.- - - - - - - - - - ranking = 0.00931438641519keywords = carcinoma (Clic here for more details about this article) |