Motor Axonal Neuropathy Associated With Idiopathic CD4(+) T-Lymphocytopenia

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.