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Panminerva Medica 1998 March;40(1):69-71

lingua: Inglese

Undefined CD4 lym­pho­cy­to­pe­nia with­out clin­i­cal com­pli­ca­tions. A ­report of ­two cas­es

Cas­cio G., Mas­so­brio A. M., Cas­cio B., Ana­nia A.

From ­the Department of Internal Medicine Chair of Internal Medicine B University of Turin, Turin, Italy


A ­form of idiopath­ic CD4 lymphocytopenia (­ICL) ­has ­been recent­ly ­described. Its diag­nos­tic cri­te­ria ­have ­been ­defined by ­the Centers ­for Disease Control (­CDC), Atlanta. Associations of ­ICL ­with hep­a­titis C infec­tion ­have ­been report­ed, ­while ­some ­ICL ­patients ­have pre­sent­ed abnor­mal­ities part­ly sim­i­lar to ­those ­observed in com­mon var­i­able immu­no­def­i­cien­cy (­CVI). This ­paper illus­trates ­the immu­no­log­i­cal pic­tures of ­two sub­jects ­with a CD4 defi­cien­cy con­firmed in a ­series of periph­er­al ­blood lym­pho­cyte sub­set deter­mi­na­tions, ­but ­not asso­ciat­ed ­with oth­er cel­lu­lar or humo­ral immu­nity abnor­mal­ities ­and accom­pa­nied by poor­ly sig­nif­i­cant clin­i­cal man­i­fes­ta­tions (no oppor­tu­nis­tic infec­tions). Patient ­one ­has ­been ­observed ­for a ­very ­long peri­od. Her ser­o­log­i­cal pic­ture ­has ­been neg­a­tive ­and ­she is ­free ­from hyper­gam­mag­lo­bu­li­ne­mia. ­HIV infec­tion ­can ­thus be ­ruled ­out. Patient ­two ­has ­not ­required ­any spe­cif­ic treat­ment so ­far. The CDC’s diag­nos­tic cri­te­ria ­for ­ICL ­are ­not ful­ly ­met in ­the ­two cas­es. Their pic­tures ­meet ­many, ­though ­not ­all of ­the ­CDC cri­te­ria ­for ­the diag­no­sis of ­ICL. It is to be ­hoped ­that a pro­tract­ed fol­low-up ­will ­allow an assess­ment to be ­made of ­the nat­u­ral his­to­ry of ­the ­two cas­es.

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