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Idiopathic CD4 Lymphocytopenia.

P K Ramalingam¹, K Gayathri¹, Rpsp Santhakumar¹

¹Post graduate.

The Journal of the Association of Physicians of India

|October 14, 2016

Summary

A 42-year-old male with idiopathic CD4 lymphocytopenia (ICL) and extrapulmonary tuberculosis showed symptom improvement with antitubercular treatment. This case highlights ICL in non-HIV adults with disseminated infections.

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Area of Science:

Immunology
Infectious Diseases
Hematology

Background:

Idiopathic CD4 lymphocytopenia (ICL) is a rare condition characterized by low CD4+ T-cell counts in the absence of HIV infection.
ICL is associated with an increased risk of opportunistic infections and certain malignancies.
The etiology and pathogenesis of ICL remain largely unknown.

Observation:

A 42-year-old male presented with symptoms suggestive of disseminated infection.
Investigations revealed low CD4+ T-cell counts on two separate occasions, meeting criteria for ICL.
The patient was also diagnosed with extrapulmonary tuberculosis and diffuse splenic calcification.

Findings:

The patient's low CD4 counts persisted despite the absence of HIV infection.
Extrapulmonary tuberculosis was identified as a significant comorbidity.
Diffuse splenic calcification was noted incidentally on imaging.

Implications:

This case underscores the importance of considering ICL in non-HIV individuals presenting with severe infections.
Antitubercular treatment led to clinical improvement, suggesting a potential link between tuberculosis and ICL in this patient.
Further research is needed to elucidate the complex interplay between ICL, infections, and splenic abnormalities.