Idiopathic CD4 lymphocytopenia

Walker, Ulrich A.; Warnatz, Klaus

doi:10.1097/01.bor.0000231908.57913.2f

Cited by 98 publications

(92 citation statements)

References 85 publications

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“…ICL is defined by the CDC as having depressed number of CD4 +T-lymphocytes at less than 300 cells per cubic millimeter or less than 20 percent of total T cells on more than one occasion three months apart and in the absence of HIV type 1 or 2 as well as any other immunodeficiency that may cause depressed levels such as Sarcoidosis, HTLV1, HTLV2 infection, or immunosuppressive therapies. Patients with ICL may range from asymptomatic to life threatening infections [2]. The condition is more commonly seen in adults but is reported in children through the elderly.…”

Section: Discussionmentioning

confidence: 99%

“…PCP infection was rare with only one reported case. There appears to be a lower rate of PCP in ICL patients compared to HIV patients so the need for prophylaxis in unclear but trends to follow the current HIV guidelines [2,3,6]. As opposed to HIV patients, those with ICL tend not to have the progressive overall decline in health and CD4 counts tend to maintain a stable level.…”

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confidence: 99%

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Cryptococcal Meningitis in a Patient with Idiopathic CD4 Lymphocytopenia

Terrell¹

2015

J Neuroinfect Dis

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A 49 year-old Caucasian man presented to the emergency department with altered mental status. His family reported that he had not felt well for several months and they had noticed slurring of his speech over this time. They urged him to seek medical evaluation but he declined. He had been able to continue his daily activities including working a manual labor job installing flooring until the past week although he was experiencing progressive fatigue over the previous month. He had no unusual chemical exposures and had not been out of the country. He had no pets and had no exposure to any exotic animals or birds. He had no significant HIV risk factors. Family reported he had developed bizarre behavior over the past week including answering the door partially undressed. He would not allow family members to come into his home but persisted in stating he was fine. Family reported he had flu like symptoms with cough, upper airway congestion, nausea and vomiting over four to five days prior to presentation. However, these symptoms had now resolved. In addition, he complained of decreased hearing in bilateral ears for the previous two to three days along with imbalance.In the emergency department he was alert and oriented, but noted to be impulsive and removed medical appliances. He requested to sign out against medical advice and tried to leave but was unsteady on his feet and unable to maintain balance, and subsequently agreed to stay. Neurology was consulted for admission. On exam he had generalized weakness, bilateral hearing loss, incoordination, truncal ataxia, nystagmus, a positive Romberg sign, severe gait ataxia, and he was unable to maintain an upright posture. His bilateral horizontal nystagmus was non-fatigable. Deep tendon reflexes (DTRs) were absent but a right Babinski sign was present. Skin exam revealed Condyloma on his penis. Initial work up included CT of the head, Complete blood count, Metabolic panel, Liver function test, blood and urine cultures were obtained. LP was attempted but initially was unsuccessful due to his body habitus.CT of the head was unremarkable. Chest radiograph was normal. Flu, Respiratory virus panel and Syphillis serologies were negative. White blood cell count was elevated at 15,000 cell/mcL with 87.2 % neutrophils and no bands. BMP, LFTs, Ammonia, Vitamin B 12, Folate and TSH and Ammonia were unremarkable. Urinalysis showed moderate ketones. CRP was elevated at 90.7 mg/L. Differential diagnosis included posterior circulation ischemia, alcohol withdrawal, meningitis, and subarachnoid space inflammatory process, an infectious process such as encephalitis, paraneoplastic syndrome, or vitamin deficiency such as Wernicke's encephalopathy. Cryptococcal Meningitis in a Patient with Idiopathic CD4 Lymphocytopenia AbstractA 49 year-old man with a past medical history of hypertension and tobacco use presented to the emergency department after being found by family with altered mental status. Over the previous few months he had experienced progressive fatigue and slurred speech. More...

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Cryptococcal Meningitis in a Patient with Idiopathic CD4 Lymphocytopenia

Terrell¹

2015

J Neuroinfect Dis

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“…Une altération fréquente consiste en une augmentation sérique d'interleukine-7 (IL-7), compatible avec le déclenchement d'une réponse homéostatique qui vise à reconstituer le taux de LT CD4 + [9]. Des études rapportent une diminution des réponses des LT, une augmentation de leur activation et une capacité accrue à entrer en apoptose [10]. Une altération de la capacité clonogénique des cellules souches hématopoïétiques de la moelle osseuse pourrait également contribuer à la déplétion des LT CD4 + [11].…”

Section: Cxcl12 Une Chimiokine Singulièreunclassified

CXCR4, une cible thérapeutique dans certains déficits immunitaires rares?

et al. 2011

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“…We also exclude the possibility that the immunosuppression status associated with the use of immunosuppressive drugs, because of all 3 patients having no history of medical using of drugs in the past. The bone marrow disease also was excluded, as the number of red blood cells and platelets were in the normal range [2,5]. Other questions were posed, whether the infection status caused the decline of the number of CD4-T or this decline caused infection diseases in these patients?…”

Section: Report On Three Patients With Decline Of Cd4 T Cells Unknownmentioning

confidence: 99%

“…In recent years, another illness that weakens the CD4 T-cells, but not associated with HIV/AIDS are also notified. In this illness, the root cause still has not been proven and considered a rare disease [4,5] The aim of this report was to inform the three cases with declining of CD4 T-cell with unknown reasons.…”

Section: Introductionmentioning

confidence: 99%