Idiopathic CD4+ T Cell Lymphocytopenia Evolving to Monoclonal Immunoglobulins and Progressive Renal Damage Responsive to IL-2 Therapy

Safety and efficacy of treatment using interleukin-2 in a patient with idiopathic CD4+ lymphopenia andMycobacterium avium-intracellulare

“…He received subcutaneous IL-2 after failing numerous anti-viral therapies and relapsing on subcutaneous IFN-g therapy [13] ) and decreased T cell proliferation capacity [14]; 3·5 years later she continued with ICL (CD4 + 136). She developed anaemia and interstitial nephritis and was found to have IgA and IgG gammopathies [14].…”

“…He received subcutaneous IL-2 after failing numerous anti-viral therapies and relapsing on subcutaneous IFN-g therapy [13] ) and decreased T cell proliferation capacity [14]; 3·5 years later she continued with ICL (CD4 + 136). She developed anaemia and interstitial nephritis and was found to have IgA and IgG gammopathies [14]. After failing a conventional chemotherapy regimen for multiple myeloma and induction chemotherapy followed by autologous stem cell rescue, the patient started subcutaneous IL-2 therapy at 380 000 IU per day and was titrated to 1 million IU per day with no relevant side effects [14].…”

“…She developed anaemia and interstitial nephritis and was found to have IgA and IgG gammopathies [14]. After failing a conventional chemotherapy regimen for multiple myeloma and induction chemotherapy followed by autologous stem cell rescue, the patient started subcutaneous IL-2 therapy at 380 000 IU per day and was titrated to 1 million IU per day with no relevant side effects [14]. Prior to beginning IL-2 therapy, her CD4 + count was 40 cells/mm 3 [14].…”

“…After failing a conventional chemotherapy regimen for multiple myeloma and induction chemotherapy followed by autologous stem cell rescue, the patient started subcutaneous IL-2 therapy at 380 000 IU per day and was titrated to 1 million IU per day with no relevant side effects [14]. Prior to beginning IL-2 therapy, her CD4 + count was 40 cells/mm 3 [14]. After 12 weeks of IL-2 therapy, when her treatment was 1 million IU IL-2 units daily, her CD4 + remained consistently above 300 cells/mm 3 , IgA and IgG gammopathies improved and renal function improved.…”

“…In the last 10 years, isolated ICL case reports have suggested that therapy with interleukin (IL)-2 is efficacious in treating Myobacterium aviumintracellulare (MAI), relapsing Herpes zoster, cryptococcal meningitis and nephritis associated with monoclonal immunoglobulin (Ig)G and IgA gammopathies following the failure of more conventional treatment regimens [12][13][14][15]. We report a case of a patient with ICL with pulmonary MAI treated with IL-2 combined with anti-microbial therapy who demonstrated marked clinical and immunological improvement.…”