Idiopathic CD4+ T Lymphocytopenia Disclosed by the Onset of Empyema Thoracis.

Hamanishi, Tohru; Nakao, Taisei; Nishino, Masaya; Yanagawa, Takuya; Kobayashi, Masato; Sasaki, Hideyuki; Matsumoto, Gensaku; Sanke, Tokio; Nanjyo, Kishio

doi:10.2169/internalmedicine.38.40

Cited by 4 publications

(2 citation statements)

References 13 publications

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“…Only English language papers were reviewed. We found 258 cases diagnosed with ICL in 143 published papers[134567891011121314151617181920212223242526272829303132333435363738394041424344454647484950515253545556575859606162636465666768697071727374757677787980818283848586878889909192939495969798…”

Section: Methodsmentioning

confidence: 99%

Idiopathic CD4 Lymphocytopenia: Spectrum of opportunistic infections, malignancies, and autoimmune diseases

2013

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Idiopathic CD4 lymphocytopenia (ICL) was first defined in 1992 by the US Centers for Disease Control and Prevention (CDC) as the repeated presence of a CD4+ T lymphocyte count of fewer than 300 cells per cubic millimeter or of less than 20% of total T cells with no evidence of human immunodeficiency virus (HIV) infection and no condition that might cause depressed CD4 counts. Most of our knowledge about ICL comes from scattered case reports. The aim of this study was to collect comprehensive data from the previously published cases to understand the characteristics of this rare condition. We searched the PubMed database and Science Direct for case reports since 1989 for Idiopathic CD4 lymphocytopenia cases. We found 258 cases diagnosed with ICL in 143 published papers. We collected data about age, sex, pathogens, site of infections, CD4 count, CD8 count, CD4:CD8 ratio, presence of HIV risk factors, malignancies, autoimmune diseases and whether the patients survived or died. The mean age at diagnosis of first opportunistic infection (or ICL if no opportunistic infection reported) was 40.7 ± 19.2 years (standard deviation), with a range of 1 to 85. One-sixty (62%) patients were males, 91 (35.2%) were females, and 7 (2.7%) patients were not identified whether males or females. Risk factors for HIV were documented in 36 (13.9%) patients. The mean initial CD4 count was 142.6 ± 103.9/mm3 (standard deviation). The mean initial CD8 count was 295 ± 273.6/mm3 (standard deviation). The mean initial CD4:CD8 ratio was 0.6 ± 0.7 (standard deviation). The mean lowest CD4 count was 115.4 ± 87.1/mm3 (standard deviation). The majority of patients 226 (87.6%) had at least one infection. Cryptococcal infections were the most prevalent infections in ICL patients (26.6%), followed by mycobacterial infections (17%), candidal infections (16.2%), and VZV infections (13.1%). Malignancies were reported in 47 (18.1%) patients. Autoimmune diseases were reported in 37 (14.2%) patients.

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Section: Methodsmentioning

confidence: 99%

Idiopathic CD4 Lymphocytopenia: Spectrum of opportunistic infections, malignancies, and autoimmune diseases

2013

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“…Manifestations reported include nasal polypoid tumors, 88 otitis media, 53 laryngeal papillomas, 63 reticulonodular infiltrates, 89 pneumonia, bronchiectasis, 53 nodules, masses, 90 cysts, mediastinal lymphadenopathy, 75 pleural effusion, 91 and empyema. 92 Organisms comprised of mycobacteria (M. tuberculosis, MAC), bacteria (Nocardia, 71 H. infleunzae), viruses (VZV, CMV, HPV, and EBV) and fungi (Pneumocystis jirovecii, 75 cryptococcosis, mucormycosis, aspergillosis, istoplasmosis 72 ). According to Ahmad et al, Pneumocystis jirovecci was the most common respiratory pathogen.…”

Section: Infectionsmentioning

confidence: 99%

<p>Idiopathic CD4 Lymphocytopenia: Current Insights</p>

Vijayakumar¹,

Viswanathan²,

Aghoram³

2020

ITT

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Idiopathic CD4 lymphocytopenia is a condition characterized by low CD4 counts. It is rare and most of the information about this illness comes from case reports. Presentation is usually in the 4th decade of life with opportunistic infections, autoimmune disease or neoplasia. The pathophysiology of this condition is not well understood. Management revolves around treatment of the presenting condition and close follow-up of these patients. This review presents a narrative summary of the current literature on idiopathic CD4 lymphocytopenia.

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Idiopathic CD4 lymphocytopenia

Walker

Warnatz

2006

Current Opinion in Rheumatology

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The manifestation of opportunistic infections calls for the evaluation of the immune system for CD4 lymphocytopenia. The differential diagnosis of this condition in adults comprises primarily HIV infection and less often other diseases or drugs. Idiopathic CD4 lymphocytopenia is very rare. The clinical significance of low CD4 cell counts in HIV negative patients still awaits its systematic analysis. Prophylaxis of opportunistic infections is oriented at the recommendations of HIV-infected individuals and causal treatment remains experimental.

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Idiopathic CD4+ T Lymphocytopenia Disclosed by the Onset of Empyema Thoracis.

Cited by 4 publications

References 13 publications

Idiopathic CD4 Lymphocytopenia: Spectrum of opportunistic infections, malignancies, and autoimmune diseases

Idiopathic CD4 Lymphocytopenia: Spectrum of opportunistic infections, malignancies, and autoimmune diseases

<p>Idiopathic CD4 Lymphocytopenia: Current Insights</p>

Idiopathic CD4 lymphocytopenia

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