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Idiopathic Cd4+T-lymphocytopenia--two unusual patients with cryptococcal meningitis

Dragan Lepur1, Zoran Vranjican, Bruno Barsić

  • 1Department of Neuroinfections and Intensive Care Medicine, University Hospital for Infectious Diseases Dr Fran Mihaljević Mirogojska 8, 10 000 Zagreb, Croatia. lepurix@inet.hr

The Journal of Infection
|July 26, 2005
PubMed

Insights

Idiopathic CD4+T-lymphocytopenia (ICL) is a rare immune disorder causing low CD4+ T-cells without HIV. This report details two ICL patients with cryptococcal meningitis, highlighting ICL

Area of Science:

  • Immunology
  • Infectious Diseases
  • Virology

Background:

  • Idiopathic CD4+T-lymphocytopenia (ICL) is defined by low CD4+ T-cell counts without HIV infection.
  • ICL patients exhibit distinct immunologic abnormalities compared to HIV-infected individuals.
  • ICL is associated with various clinical conditions, notably opportunistic infections.

Observation:

  • Two patients presented with cryptococcal meningitis.
  • Neither patient had risk factors for human immunodeficiency virus (HIV) infection.
  • Both patients were diagnosed with idiopathic CD4+T-lymphocytopenia (ICL).

Findings:

  • Idiopathic CD4+T-lymphocytopenia (ICL) was confirmed in both cases.
  • One patient experienced co-infection of the central nervous system with Epstein-Barr virus (EBV) and cytomegalovirus (CMV).

Implications:

  • This case series underscores the association between ICL and severe opportunistic infections like cryptococcal meningitis.
  • The findings suggest ICL should be considered in the differential diagnosis of unexplained CD4+ T-cell depletion, especially with opportunistic infections.
  • Further research is needed to understand the pathogenesis of ICL and its link to viral coinfections.

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