title: Human T-lymphotropic virus type I-associated benign transient immature T-cell lymphocytosis.
abstract: We describe a case of human T-lymphotropic virus type I (HTLV-I)-associated transient benign immature T-cell lymphocytosis in a black female patient, which over the course of several months underwent spontaneous complete remission. The patient presented with a white blood cell count of 20,000/microliter and a T4/T8 ratio of 1.7:1. The majority of cells appeared to be lymphoid in origin, and cell marker analyses established that the circulating lymphocytes were predominantly immature T-cells. HTLV-I was detected at this time by a p19 indirect immunofluorescent slide assay. Over a 1-month period of time the patient's clinical status evolved into a mature T-lymphocytosis with a T4/T8 ratio of 4.5:1. HTLV-I was detected by anti-p19 immunofluorescence by cell sorter analyses and by dot-bloc nucleic acid hybridization. Serological testing demonstrated that the patient had anti-HTLV-I antibodies and antimembrane antibodies specific for an HTLV-I producing cell line. In a competitive HTLV-I ELISA assay only HTLV-I proteins could effectively compete out the seroreactivity. The patient also had a high serum level of soluble interleukin-2 (IL-2) receptors, which is associated with HTLV-I infection. This is the first reported case of immature T-lymphocytosis in a patient infected with HTLV-I. The patient's HTLV-I markers disappeared with time, and her lymphocytosis subsequently spontaneously resolved. She remains disease free and virus negative after 2 years of follow-up study.
authors.affiliation: Department of Medicine, SUNY HSC, Syracuse 13210.
authors.forename: G D
authors.initials: GD
authors.lastname: Ehrlich
authors.forename: T
authors.initials: T
authors.lastname: Han
authors.forename: R
authors.initials: R
authors.lastname: Bettigole
authors.forename: S A
authors.initials: SA
authors.lastname: Merl
authors.forename: B
authors.initials: B
authors.lastname: Lehr
authors.forename: R H
authors.initials: RH
authors.lastname: Tomar
authors.forename: B J
authors.initials: BJ
authors.lastname: Poiesz
mesh_terms: D000914:Antibodies, Viral / Q000032:analysis; D002454:Cell Differentiation; D002460:Cell Line; D002472:Cell Transformation, Viral; D004247:DNA / Q000302:isolation & purification; D017977:Deltaretrovirus / Q000235:genetics / Q000276:immunology; D005260:Female; D006801:Humans; D007075:Immunoglobulin M / Q000032:analysis; D008218:Lymphocytosis / Q000209:etiology* / Q000276:immunology / Q000473:pathology; D008875:Middle Aged; D013601:T-Lymphocytes / Q000276:immunology / Q000473:pathology*; D014764:Viral Proteins / Q000032:analysis
chemical_list: D000914:Antibodies, Viral; D007075:Immunoglobulin M; D014764:Viral Proteins; D004247:DNA