Detection of CD4(+) T-cell antibodies in a patient with idiopathic CD4 T lymphocytopenia and cryptococcal meningitis |
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Authors: | Salit Rachel B Hankey Kim G Yi Rosemary Rapoport Aaron P Mann Dean L |
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Institution: | Department of Internal Medicine, The University of Maryland Medical Center, Baltimore, MD 21201, USA. rsalit@earthlink.net |
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Abstract: | Idiopathic CD4(+) T lymphocytopenia (ICL) is defined as a CD4(+) T-cell count <0.3 x 10(9)/l or <20% of the total T-cell count on two occasions in the absence of any immunodeficiency disorder or therapy associated with reduced CD4(+) T-cell count. Although several mechanisms of ICL have been reported, the pathophysiology is still largely unknown. This case report describes a patient who presented with cryptococcal meningitis and was subsequently discovered to meet the criteria for ICL. Flow cytometric analysis of the patient's peripheral blood mononuclear cells revealed antibodies coating a much larger proportion of his CD4(+) T cells (33.61%) than the CD4(+) T cells of normal donors (3.94 +/- 1.77%). The reasons behind the development of these autoantibodies are explored. |
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Keywords: | T-cell depletion antibodies cryptococcosis monoclonal gammopathy of undetermined significance immunoglobulin |
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