Common variable hypogammaglobulinemia with T-cell nodular lymphoid interstitial pneumonitis and B-cell nodular lymphoid hyperplasia: different lymphocyte populations with a similar response to prednisone therapy.
Intestinal lymphoid hyperplasia and recurrent pulmonary infections by pyogenic bacteria are well-recognized accompaniments of common variable (late onset) hypogammaglobulinemia. A 35-yr-old woman with this illness had progressive pulmonary insufficiency caused by nodular lymphoid interstitial pneumonitis, rather than by infectious lung damage, and intestinal lymphoid nodular hyperplasia. B cells were abundant in the intestinal nodules but absent in the pulmonary nodules by immunoperoxidase staining. Pulmonary lymphocytes isolated in single-cell suspension from the biopsy were 0.5% B cells and 82% T cells. Prednisone therapy improved pulmonary function and decreased the intestinal lymphoid nodules. Lymphocytic interstitial pneumonitis should be considered in patients with hypogammaglobulinemia and restrictive lung disease.
D000328:Adult; D000361:Agammaglobulinemia / Q000150:complications* / Q000188:drug therapy / Q000276:immunology; D001402:B-Lymphocytes; D005260:Female; D006801:Humans; D006965:Hyperplasia / Q000188:drug therapy / Q000276:immunology; D008168:Lung / Q000276:immunology / Q000473:pathology; D008198:Lymph Nodes / Q000276:immunology / Q000473:pathology; D011241:Prednisone / Q000627:therapeutic use*; D011658:Pulmonary Fibrosis / Q000150:complications* / Q000188:drug therapy / Q000276:immunology; D013902:Radiography, Thoracic; D012007:Rectum / Q000276:immunology / Q000473:pathology; D013601:T-Lymphocytes
D011241:Prednisone