       Document 1174
 DOCN  M94A1174
 TI    Idiopathic CD4+ T-lymphocytopenia accompanying hypogammaglobulinemia
       with increased CD5+ B lymphocytes.
 DT    9412
 AU    Fujiyama Y; Hodohara K; Yoshida T; Matsubara H; Bamba T; Dept. Int.
       Med., Shiga Univ. Med., Otsu, Japan.
 SO    Int Conf AIDS. 1994 Aug 7-12;10(2):192 (abstract no. PB0780). Unique
       Identifier : AIDSLINE ICA10/94371401
 AB    Idiopathic CD4+ T-lymphocytopenia (ICTL) is an acquired immunodeficiency
       in which no evidence for HIV type 1 and type 2 infection was found. Here
       we report a case of ICTL accompanying profound hypogammaglobulinemia
       with increased CD5+ B lymphocytes. A 36 year old japanese man was
       refered to our university hospital on June 1993 for
       hypogammaglobulinemia developed after an episode of acute hepatitis. He
       had no past history suggesting preceded immunodeficiency nor any risk
       factor of HIV infection. The serum immunoglobulins levels were decreased
       from 733 to 467 for IgG, from 108 to 10 for IgA and from 50 to 22 mg/dl
       for IgM in about one month from the clinical onset of acute hepatitis.
       Absolute peripheral blood lymphocyte counts was 1632/mm3 and the
       immunophenotyping studies of peripheral lymphocytes revealed; CD3+ 43%,
       CD19+ 33%, CD4+ 5%, CD8+ 35%, CD8+CD57+ 30%, CD5+CD20+ 30%, Sm-kappa+
       17%, Sm-lambda+ 2%, CD16+ 26%. He had no evidence of HIV-1, 2 infection,
       as judged by multiple serologies, syncytium formation assay using MT4
       cells, and HIV-1 proviral DNA amplification by PCR. Serologies of HAV,
       HBV, HCV, CMV, EBV and HTLV-1 were negative, and PCR failed to
       demonstrate HBV-DNA, HCV-RNA, EBV-DNA, HSV-DNA, HHV6-DNA and CMV-DNA. In
       vitro proliferative responses of PBMC to PHA and Con A were both
       remarkably suppressed (1,768 cpm for PHA and 2,055 cpm for Con A,
       respectively). Bone marrow aspirate was morphologically normal, and
       rearrangement band of TCRs, Ig heavy and light chains of PBMC was not
       detected by PCR. Nevertheless, the absolute CD4+ T-cell counts had been
       remained below 100/mm3 over 8 months of observation, he had been
       uneventful without any opportunistic infection until February 1994, when
       Herpes zostor infection developed. Although, any viral activity has not
       been, so far, demonstrated, the increased CD5+ B lymphocyte might be
       indicative of autoimmune mechanism induced by some infectious agent
       causing acute hepatitis.
 DE    Acute Disease  Adult  Agammaglobulinemia/BLOOD/COMPLICATIONS/*IMMUNOLOGY
       Antigens, CD/*BLOOD  B-Lymphocyte Subsets/*IMMUNOLOGY  Bone
       Marrow/PATHOLOGY  Case Report  Cells, Cultured  Concanavalin A  Gene
       Rearrangement, T-Lymphocyte  Genes, Immunoglobulin
       Hepatitis/BLOOD/COMPLICATIONS/IMMUNOLOGY  Human  IgA/BLOOD  IgM/BLOOD
       Immunoglobulins, Heavy-Chain/GENETICS  Immunoglobulins,
       Light-Chain/GENETICS  Lymphocyte Transformation  Male
       Phytohemagglutinins  Polymerase Chain Reaction  T-Lymphocytopenia,
       Idiopathic CD4-Positive/BLOOD/COMPLICATIONS/  *IMMUNOLOGY  MEETING
       ABSTRACT

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).

