Idiopathic CD4+ T-lymphocytopenia is a rare immune disorder characterized by an unexplained deficit of CD4+ T cells and results in various opportunistic infections. Herein, we report a case of new onset weakness in a 10-year-old boy secondary to motor axonal neuropathy associated with idiopathic CD4+ T-lymphocytopenia. The patient was referred to rehabilitation for an evaluation of progressive weakness involving all four limbs. A subsequent nerve conduction study and needle electromyography identified motor axonal neuropathy. At that time, laboratory studies specific to the differential diagnosis of motor axonal neuropathy were performed; however, the abnormality noted was a decreased CD4+ T-lymphocyte count. Motor axonal neuropathy represents an uncommon manifestation of idiopathic CD4+ T-lymphocytopenia and is probably associated with an underlying immune process.
Axons ; Diagnosis, Differential ; Electromyography ; Extremities ; Humans ; Immune System Diseases ; Lymphopenia ; Needles ; Neural Conduction ; Opportunistic Infections ; T-Lymphocytes ; T-Lymphocytopenia, Idiopathic CD4-Positive

We describe a case of idiopathic CD4+ T-lymphocytopenia (ICL) in a 59-year-old patient who presented with various opportunistic infections. The patient was diagnosed with disseminated Mycobacterium avium infection, cytomegalovirus colitis and retinitis, and esophageal candidiasis. He was successfully treated with anti-mycobacterial drugs, ganciclovir, and fluconazole, respectively. However, the patient was diagnosed with primary central nervous system lymphoma, and then died of a Trichosporon beigelii sepsis during the 2nd cycle of systemic chemotherapy.
Candidiasis ; Central Nervous System ; Colitis ; Cytomegalovirus Infections ; Fluconazole ; Ganciclovir ; Humans ; Lymphoma ; Lymphopenia ; Middle Aged ; Mycobacterium avium ; Opportunistic Infections ; Retinitis ; Sepsis ; T-Lymphocytopenia, Idiopathic CD4-Positive ; Trichosporon

Idiopathic CD4+ T lymphocytopenia (ICL) is a new disease entity characterized by depletion of helper T cells apparently without any evidence of HIV infection. We report a case of ICL associated with Kaposis sarcoma (KS) and pneumocystis carinii pneumonia (PCP) in a 34-year old woman. She developed violaceous, protruding masses on scalp, back, both extremities, palms, soles, left. first toe and peritonsillar region for 2 months. These lesions were confirmed as KS by histopathologic findings. Chest X-ray and HRCT findings represented PCP and KS. Absolute deficiency of CD4+ T cell was detected in the count of T cell subsets. Serologic tests for HIV-1, 2 and HTLV I, -II were negative. And she was absent any defined immunodeficiency or therapy associated with decreased levels of CD4+ T cells. By CDC criteria, a diagnosis of ICL was made. Because of aggravation of PCP and lung involuement of KS, she died at 22nd day after admission.
Adult ; Centers for Disease Control and Prevention (U.S.) ; Diagnosis ; Extremities ; Female ; HIV Infections ; HIV-1 ; Humans ; Lung ; Lymphopenia* ; Pneumonia, Pneumocystis ; Sarcoma, Kaposi* ; Scalp ; Serologic Tests ; T-Lymphocyte Subsets ; T-Lymphocytes ; T-Lymphocytes, Helper-Inducer ; T-Lymphocytopenia, Idiopathic CD4-Positive ; Thorax ; Toes

The immune response to any stimulus is complex, requiring coordinated action by several types of cells in a tightly regulated sequence. Thus, a physical stress such as exercise may act at any number of points in the complex sequence of events collectively termed the immune response. Although exercise causes many propound changes in parameters of immune function, the nature and magnitude of such changes rely on several factors including the immune parameters of interest; type, intensity, and duration of exercise; fitness level or exercise history of the subject; environmental factors such as ambient temperature and humidity. Although regular moderate exercise appears to be important factor for increasing immunity, Athletes are susceptible to illness, in particular upper respiratory track infection, during periods of intense training and after competition. In addition, in elite athletes, frequent illness is associated with overtraining syndrome, a neuroendocrine disorder resulting from excessive training. Through this paper, we want to investigate the effects of exercise on the immunosuppression such as exercise induced lymphopenia, asthma, anaphylaxis, URT (upper respiratory track), and TB (tuberculosis) infection. and also, we want to suggest a direct mechanism, protection and therapy of exercise induced immunosuppression.
Anaphylaxis ; Asthma ; Athletes ; Humans ; Humidity ; Immunosuppression ; Lymphopenia

Papuloerythroderma of Ofuji is a rare, distinctive clinical entity characterized by a widespread pruritic eruption of coalescence of flat-topped erythematous papules producing an erythroderma with sparing of the skin folds (the 'deck-chair' sign). Other common features of papuloerythroderma are blood eosinophilia, lymphopenia, a raised serum IgE and a nonspecific or eczematous-like histopathologic feature. Its etiology has been reported as variable, and the condition is thus considered as a pattern of cutaneous expression induced by a range of pathological process for systemic disease. We experienced a 71-year-old male patient with a 4-month history of a generalized pruritic eruption which clinical features were compatible with papuloerythroderma of Ofuji. Treatment with systemic steroid resulted in marked improvement.
Aged ; Dermatitis, Exfoliative ; Eosinophilia ; Humans ; Immunoglobulin E ; Lymphopenia ; Male ; Skin

CD4-Positive T-Lymphocytes ; Child ; Cryptococcosis ; immunology ; Humans ; Lymphopenia ; etiology

PURPOSE: We evaluated the clinical/laboratory characteristics and progress of pediatric patients hospitalized for pneumonia and laboratory-confirmed H1N1 influenza infection. METHODS: A total of 101 patients were enrolled. They were divided into 2 groups: group 1 with a fast respiration rate for age (n=66) and group 2 with an appropriate respiration rate for age (n=35). We retrospectively reviewed the medical charts to collect data on the hospitalized patients. RESULTS: Patients were significantly older in group 1 than in group 2 (median age, 7 vs. 4 years, p<0.001) and 59.0% were between 6 and 8 years of age. Sixteen patients (24.2%) in group 1 had underlying medical conditions, most of whom had asthma, and 50 were previously healthy. Oxygen saturation on admission day was significantly lower in group 1 than in group 2 (92% vs. 98%, p<0.001) and 42 patients (63.6%) in group 1 had hypoxia (oxygen saturation <= 92%). The frequency of lymphopenia was significantly higher in group 1 than in group 2 (n=59 vs. 11, p<0.001). Some patients in group 1 received systemic corticosteroid therapy, intravenous immunoglobulin infusion and oxygen supplement (n=28, n=16, n=48, respectively). The frequency of systemic corticosteroid therapy and oxygen supplement was higher in group 1 than in group 2 (p<0.001 for each). CONCLUSION: H1N1 influenza infection complicated by pneumonia can cause severe illness in previously healthy children more than 6 years old and in children with uncontrolled allergic disease. Multi-center studies are needed to evaluate the clinical and epidemiologic characteristics of pediatric patients with 2009 H1N1 influenza.
Anoxia ; Asthma ; Child ; Humans ; Immunoglobulins ; Influenza, Human ; Lymphopenia ; Oxygen ; Pneumonia ; Respiratory Rate ; Retrospective Studies ; Tachypnea

BACKGROUND: Advances in the understanding of Hodgkin's lymphoma (HL) show various functions of infiltrating immune cells and cytokines in relation to clinical outcomes. The expression of CD163 and c-Met has been suggested to have a role in lymphoid malignancy. Thus, we evaluated the expressions of CD163, c-Met, and serum free light chain (sFLC) in relation to the clinicopathological features of patients with advanced classical HL (cHL). METHODS: We assessed the expression of CD163 and c-Met in 34 patients with cHL through immunohistochemistry on the lymph node biopsy sections and the levels of pretreatment sFLC were estimated using ELISA. RESULTS: High CD163 expression correlated with increased age, B symptoms, International Prognostic Score (IPS) > or =3, mixed cellularity subtype, and low response to treatment. Further, high c-Met expression correlated with increased age at diagnosis, leukocytosis, B symptoms, and lower chance to achieve complete remission. The sFLC levels correlated with increased age at diagnosis, lymphopenia, IPS > or =3, B symptoms, and lower complete remission rates. CONCLUSION: In advanced cHL, increased expression of CD163 and c-Met showed a significant association with adverse prognostic parameters and poor response to treatment. Pretreatment high sFLC level also correlated with poor risk factors, suggesting its use as a candidate prognostic marker. A comprehensive approach for prognostic markers might represent a step towards developing a tailored therapeutic approach for HL.
Biopsy ; Cytokines ; Hodgkin Disease ; Humans ; Immunohistochemistry ; Leukocytosis ; Light ; Lymph Nodes ; Lymphopenia ; Risk Factors

There have been some 50 reports on the blood pictures of leprosy patients, but all of them have been dealt with the peripheral blood and more over each investigator presented the different data. In order to find cut the typical blood pictures both peripheral and bone marrow as well as the blood pictures between the various types of leprosy and the nature of anemia brought about after the use of D.D.S. derivatives, the author examined the blood of 53 cases of early leprosy patients with the following results: 1. Peripheral Blood Pictures: a. About one third of leprosy patients showel the anemic blood picture and one half of T type leprosy cases gave the anemic picture. Almost all of them were normocytic and hypochromic anemia. b. Shift to the left was found in about 50% of the cases. c. Eosinophilia was observed in the majority of the cases and all of the T type showed eosinophilia. d. There was found lymphocytosis in approximately one third of total cases and half of T type patients showed lymphocytosis. e. Lymphopenia was encountered in one fourth of them and was most frequently seen in L type patients. F. About half of all cases showed monocytopenia. g. Only 10% of patients showed the accelaration in Erythrocyte Sedimentation Rate. 2. Bone Marrow Findings: a. Myeloblastosis was noted in about 50% of them and more frequently seen in T type and I group than the other types. b. There was observed eosinophilia in almost all cases and especially its frequency was higher in T type and I group. c. Lymphocytosis was found in about one third of the total eases and its frequency was highest in L type. whereas in the peripheral blood the lymphocytosis was most frequently seen in T type. d. Plasmocytosis was noted in the majority of the patients and was found in all cases of T type and I group. 3. Seventy percent of the cases showed the increased WBC alkaline phosphatase. 4. No granulomatous changes or any other pathological changes were noted in the histological section of the bone marrow
Alkaline Phosphatase ; Anemia ; Anemia, Hypochromic ; Blood Sedimentation ; Bone Marrow ; Eosinophilia ; Humans ; Leprosy* ; Lymphocytosis ; Lymphopenia ; Research Personnel

Primary intestinal lymphangiectasia is a congenital lymphatic disorder characterized by dilated intestinal lacteals resulting in lymph leakage into the small bowel lumen and responsible for protein losing enteropathy. As a result, generalized edema, hypoalbuminemia, and lymphocytopenia are clinically manifested. We could not find the reason by several examinations. Therefore, we performed double balloon enteroscopy (DBE), and intestnal lymphangiectasia was diagnosed histologically by a biopsy. DBE is a safe and effective method to diagnose small bowel lymphangiectasia. We report a case of primary intestinal lymphangiectasia, which occurred in a 54-year-old male patient with generalized edema and ascites.
Ascites ; Biopsy ; Double-Balloon Enteroscopy ; Edema ; Humans ; Hypoalbuminemia ; Lymphopenia ; Male ; Protein-Losing Enteropathies