title: Pulmonary miliary tuberculosis and T-cell abnormalities in a severe combined immunodeficient patient reconstituted with haploidentical bone marrow transplantation.
abstract: We report the development of miliary tuberculosis in a 7-year-old boy with severe combined immunodeficiency (SCID), whose immune system had been only partially reconstituted by haploidentical bone marrow transplantation. Although alpha beta and gamma delta T cells were of donor origin, alpha beta T cells in this patient showed defective interleukin-2 (IL-2) production, impaired IL-2 responsiveness and decreased cytolytic activity. However, gamma delta T cells could exhibit enough cytolytic activity after incubation with IL-2. Despite the presence of disseminated infection, C-reactive protein (CRP) remained negative. IL-2 therapy aggravated the disseminated tuberculosis though gamma delta T cells were supposed to be activated, and concurrently CRP became positive. These findings suggest that gamma delta T cells have no more than limited immunological roles in mycobacterium tuberculosis infection.
authors.affiliation: Department of Pediatrics, School of Medicine, Tokyo Medical and Dental University, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Nagasawa
authors.forename: H
authors.initials: H
authors.lastname: Maeda
authors.forename: H
authors.initials: H
authors.lastname: Okawa
authors.forename: J
authors.initials: J
authors.lastname: Yata
mesh_terms: D016026:Bone Marrow Transplantation; D002648:Child; D006648:Histocompatibility; D006801:Humans; D008297:Male; D016511:Severe Combined Immunodeficiency / Q000276:immunology / Q000628:therapy*; D013601:T-Lymphocytes / Q000276:immunology*; D014184:Transplantation, Homologous; D014391:Tuberculosis, Miliary / Q000150:complications*; D014397:Tuberculosis, Pulmonary / Q000150:complications*