Cases reported "Opportunistic Infections"

Filter by keywords:



Filtering documents. Please wait...

11/20. Protracted cutaneous disorders in association with low CD4 lymphocyte counts.

    We report two patients with skin disorders usually associated with severe immunosuppression, who had low CD4 lymphocyte counts but normal immunoglobulin levels. The patients were hiv negative, and had CD4 lymphocyte counts just above 300/mm3, but they presented with cutaneous manifestations of profound immunodeficiency. Idiopathic CD4 lymphocyte deficiency is a recently described syndrome which may present with dermatological disease. We discuss the symptom complex of our patients in relationship to the diagnosis of idiopathic CD4 lymphocyte deficiency.
- - - - - - - - - -
ranking = 1
keywords = idiopathic
(Clic here for more details about this article)

12/20. A unique syndrome of immunodeficiency and autoimmunity associated with absent T cell CD2 expression.

    CD2 is a glycoprotein expressed on the surface of human T cells that mediates adhesion between T cells and antigen presenting cells. CD2 also functions in concert with the T cell receptor to transduce signals that lead to T cell activation. The CD8 and CD4 molecules are transmembrane glycoproteins that are expressed on mutually exclusive populations of mature T cells and bind to determinants on major histocompatibility complex class I and class II molecules respectively. Like CD2, CD4 and CD8 function to promote adhesion between T cells and antigen presenting cells and potentiate signaling via the T cell receptor. We studied a patient with idiopathic lymphopenia and disseminated infection with mycobacterium avium. The patient also suffered from recurrent deep venous thrombosis in association with anticardiolipin and anti-dna antibodies. Peripheral blood T cells from this patient were polyclonal and expressed no detectable CD2 rna or protein as determined by northern blotting, immunofluorescent staining with anti-CD2 antibodies, and failure to form rosettes with sheep red blood cells. In addition, the majority (85%) of this patient's T cells did not express either CD4 or CD8 but did express the alpha/beta T cell receptor. T cells from this patient failed to respond to stimulation with alloantigen or specific antigen. In contrast, there was a normal response to stimulation with immobilized anti-CD3 antibody. The clinical and immunologic findings in this patient provide in vivo evidence that the accessory molecules CD2, CD4, and CD8 play important roles in the regulation of normal human T cell activation.
- - - - - - - - - -
ranking = 1
keywords = idiopathic
(Clic here for more details about this article)

13/20. Idiopathic CD4 T-lymphocytopenia--an analysis of five patients with unexplained opportunistic infections.

    BACKGROUND. Although patients with idiopathic CD4 T-lymphocytopenia and serious opportunistic infections have been described previously, the clinical and immunologic features of this condition have not been well defined. methods. We studied in detail five patients with idiopathic CD4 T-lymphocytopenia. The studies included serologic testing, culture, and polymerase chain reaction for the human immunodeficiency virus (hiv) types 1 and 2, serologic testing for the human T-cell lymphotropic virus (HTLV) types I and II, lymphocyte phenotyping, immunoglobulin quantitation, and lymphocyte-transformation assays, as well as attempts to isolate a retroviral agent. The results were compared with those in hiv-infected persons matched for CD4 T-cell counts and with those in normal controls. We also studied the spouses of patients and the blood donors for one patient. RESULTS. In these five patients, there was no evidence of either hiv or HTLV infection. All the patients had both low percentages and low counts of CD4 T cells, with relative increases in percentages, but not counts, of CD8 cells. Numbers of B cells and natural killer cells were generally normal. As compared with hiv-infected persons, our patients had lower percentages and counts of CD8 cells and more lymphopenia. CD4 counts were relatively stable over time. Instead of the high immunoglobulin levels seen in hiv infection, these patients had normal or slightly low levels of immunoglobulins. The lymphocyte-transformation response to mitogens and antigens was depressed. Results in spouses and blood donors were normal. CONCLUSIONS. Idiopathic CD4 T-lymphocytopenia differs from hiv infection in its immunologic characteristics and in its apparent lack of progression over time. Nothing about the immunologic or viral-culture studies performed in these patients or about their family members or blood donors suggests that a transmissible agent causes this condition.
- - - - - - - - - -
ranking = 2
keywords = idiopathic
(Clic here for more details about this article)

14/20. Idiopathic CD4 T-lymphocytopenia--four patients with opportunistic infections and no evidence of hiv infection.

    BACKGROUND AND methods. We describe four patients without major risk factors for human immunodeficiency virus (hiv) infection, each of whom presented with severe opportunistic infections and was found to have idiopathic CD4 T-lymphocytopenia. We performed assays to detect the presence of retroviruses and undertook immunophenotyping of subgroups of peripheral-blood lymphocytes. RESULTS. The opportunistic infections at presentation included pneumocystis carinii pneumonia, cryptococcal meningitis (two patients, one with concurrent pulmonary tuberculosis), and histoplasma-induced brain abscess. During 10 to 68 months of observation, none of the four patients had evidence of infection with hiv type 1 or 2 or human T-cell lymphotropic virus type I or II on the basis of epidemiologic, serologic, or polymerase-chain-reaction studies or culture, nor was there any detectable reverse transcriptase activity. Although all the patients had severe, persistent CD4 T-lymphocytopenia (range, 12 to 293 cells per cubic millimeter), the CD4 cell count progressively declined in only one and was accompanied by multiple opportunistic infections. All four patients had significantly reduced numbers of circulating CD8 T cells, natural killer cells, or B cells (or all three). CONCLUSIONS. These four patients had idiopathic CD4 T-lymphocytopenia with opportunistic infections but no evidence of hiv infection. Instead of the progressive, selective depletion of CD4 T cells characteristic of hiv infection, some patients with idiopathic immunodeficiency have stable CD4 cell counts accompanied by reductions in the levels of several other lymphocyte subgroups.
- - - - - - - - - -
ranking = 3
keywords = idiopathic
(Clic here for more details about this article)

15/20. Photoaccentuated erythroderma associated with CD4 T lymphocytopenia: successful treatment with 5-methoxypsoralen and UVA, interferon alfa-2b, and extracorporeal photopheresis.

    We describe a 53-year-old hiv-negative white man who had chronic CD4 T lymphocytopenia and photoaccentuated erythroderma with lymphoma-like histologic changes. The erythroderma completely responded to 5-methoxypsoralen and UVA (PUVA), interferon alfa-2b, and extracorporeal photopheresis. During therapy opportunistic skin infections, including tinea corporis, warts, and disseminated molluscum contagiosum, developed. Although the patient met the current definition of idiopathic CD4 T lymphocytopenia (ICTL), we cannot rule out the possibility that this peripheral CD4 T lymphocytopenia resulted from sequestration of CD4 T lymphocytes in erythrodermic skin.
- - - - - - - - - -
ranking = 1
keywords = idiopathic
(Clic here for more details about this article)

16/20. Idiopathic CD4 lymphocytopenia and systemic vasculitis.

    The syndrome defined as "idiopathic CD4 lymphocytopenia' (ICL) is a rare disease of unknown aetiology, often associated with severe depression of immune defences and the occurrence of opportunistic infections. A case is reported wherein a severe immunodeficiency syndrome with persistent idiopathic CD4 lymphopenia developed in a woman suffering from systemic microscopic polyarteritis; no signs of hiv 1/2 or HTLV I/II infection were evident. The patient died of widespread opportunistic infections. The association of ICL with vasculitis has never been reported until now. A link between the two diseases cannot be ruled out.
- - - - - - - - - -
ranking = 2
keywords = idiopathic
(Clic here for more details about this article)

17/20. Allogeneic bone marrow transplantation can restore CD4 T-lymphocyte count and immune function in idiopathic CD4 T-lymphocytopenia.

    CD4 T-lymphocytopenia in the absence of hiv infection is a heterogeneous disorder of unknown cause. Here we report a patient with idiopathic CD4 T-lymphocytopenia, presenting with an opportunistic rhodococcus equi infection. When aplastic anemia developed subsequently, allogeneic bone marrow transplantation was performed. Complete restoration of immune function was observed. We conclude that allogeneic bone marrow transplantation presents a potentially curative therapy for CD4 T-lymphocytopenia.
- - - - - - - - - -
ranking = 5
keywords = idiopathic
(Clic here for more details about this article)

18/20. Behcet's-like syndrome associated with idiopathic CD4 T-lymphocytopenia, opportunistic infections, and a large population of TCR alpha beta CD4- CD8- T cells.

    Herein we report a patient with Behcet's like syndrome, idiopathic CD4 T-lymphocytopenia, opportunistic infections, and a large polyclonal population of TCR alpha beta CD4- CD8- T cells. Microfluorimetric analysis of peripheral blood mononuclear cells revealed CD4 T-cell counts of 10 /- 5/mm3. The CD3 T cells were 99% TCR alpha beta , of which 74 /- 5% were CD4- CD8-. No clonal populations were detected by southern analysis for T-cell receptor V beta gene rearrangements. No evidence of human immunodeficiency virus infection was present, although nocardia, candida, pneumocystis, cytomegalovirus, and herpes infections were documented. The concomitant presence of opportunistic infections and a large population of TCR alpha beta CD4- CD8- T cells suggests a pathogenic association and an intense immune response to microbial lipid or lipoglycan antigens presented in the context of CD1 molecules. This case demonstrates the potential for idiopathic CD4 T-lymphocytopenia to occur in Behcet's-like syndrome with lethal consequences.
- - - - - - - - - -
ranking = 6
keywords = idiopathic
(Clic here for more details about this article)

19/20. 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 = 5
keywords = idiopathic
(Clic here for more details about this article)

20/20. Two cases of idiopathic CD4 T-lymphocytopenia in elderly patients.

    We present 2 cases of idiopathic CD4 T-lymphocytopenia (ICL) in elderly patients. Case 1, a 73-year-old man, with pneumonia had received several antibiotics with unsuccessful results at another hospital. On admission, his CD4 T-lymphocyte count was 109/microl and pneumocystis carinii was detected by bronchoalveolar lavage fluid staining. No evidence of human immunodeficiency virus (hiv) infection was found. Despite therapy, the patient died of respiratory failure. Case 2, a 72-year-old man, contracted severe pneumonia, and Hemophillus influenzae was believed to be the pathogen. On admission, his CD4 T-lymphocyte count was 238/microl. No evidence of hiv infection was found. He received antibiotics and improved successfully. We suggest that ICL may currently be incubating in a number of elderly pneumonia patients.
- - - - - - - - - -
ranking = 5
keywords = idiopathic
(Clic here for more details about this article)
<- Previous || Next ->


Leave a message about 'Opportunistic Infections'


We do not evaluate or guarantee the accuracy of any content in this site. Click here for the full disclaimer.