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CD4+ lymphocytopenia due to common variable immunodeficiency mimicking AIDS
R S Kaczmarski1, A D Webster, J Moxham
1Department of Haematological Medicine, King's College School of Medicine and Dentistry, London.
Insights
Common Variable Immunodeficiency (CVID) can mimic acquired immunodeficiency syndrome (AIDS) by causing low CD4+ counts. This highlights CVID as a crucial diagnosis in patients presenting with unexplained CD4+ lymphopenia.
Area of Science:
- Immunology
- Infectious Diseases
Background:
- Acquired immunodeficiency without HIV infection is increasingly reported, often termed idiopathic CD4+ lymphocytopenia.
- Idiopathic CD4+ lymphocytopenia presents with clinical and laboratory features similar to Acquired Immunodeficiency Syndrome (AIDS).
Observation:
- A case of a young man presenting with Pneumocystis carinii pneumonia (PCP) and CD4+ lymphopenia is described.
- The patient also exhibited hypogammaglobulinaemia, a key indicator of immune deficiency.
Findings:
- The patient's condition was attributed to Common Variable Immunodeficiency (CVID).
- This case demonstrates that CVID can manifest with symptoms overlapping those of AIDS and idiopathic CD4+ lymphocytopenia.
Implications:
- Common Variable Immunodeficiency (CVID) should be considered in the differential diagnosis of patients with CD4+ lymphopenia.
- Recognizing CVID in such cases is critical for accurate diagnosis and appropriate patient management.
- This underscores the importance of comprehensive immunological evaluation beyond HIV testing.
Abstract:
There are an increasing number of published reports of patients with acquired immunodeficiency without evidence of HIV infection, who have been labelled as having "idiopathic CD4+ lymphocytopenia". The case is reported here of a young man who presented with Pneumocystis carinii pneumonia (PCP), CD4+ lymphopenia, and hypogammaglobulinaemia attributable to common variable immunodeficiency (CVID). The presentation of this condition, with many of the clinical and laboratory features of AIDS, highlights CVID as a diagnosis to be considered in the differential diagnosis of CD4+ lymphocytopenia.