Successful immunosuppressive therapy with cyclosporine A for posthepatitis B-cell deficiency with activated cytoplasmic interferon--gamma-positive T-lymphocytes.
We describe a patient with transient disappearance of B-cells, hypogammaglobulinemia, and mild pancytopenia after acute hepatitis. Both HLA-DR+CD8+ and intracellular interferon-gamma+/interleukin-4- cell levels were markedly increased, resulting in an increase in the cytotoxic T-cell (T(C))1/Tc2 and helper T-cell (T(H))1/T(H)2 ratios. After immunosuppressive therapy with cyclosporine A, these parameters of T-cell activation were clearly decreased, and hematologic recovery, including an increase in B-lymphocytes and immunoglobulin concentration, was obtained. These results suggest that there had been suppression of B-cells by activated T-cells. Some patients with common variable immunodeficiency show similar activation of T-cell function, and the present findings suggest the possibility of immunosuppressive therapy for such patients.
Otsubo
Hiroko
H
Department of Internal Medicine, Jikei University, School of Medicine, Tokyo, Japan.
Kaito
Ken
K
Ogasawara
Yoji
Y
Shimada
Takaki
T
Usui
Noriko
N
Kobayashi
Masayuki
M
D000328:Adult; D015703:Antigens, CD / Q000097:blood; D001402:B-Lymphocytes / Q000187:drug effects / Q000276:immunology*; D016572:Cyclosporine / Q000627:therapeutic use*; D003593:Cytoplasm / Q000276:immunology; D005260:Female; D006684:HLA-DR Antigens / Q000097:blood; D006525:Hepatitis, Viral, Human / Q000097:blood / Q000188:drug therapy* / Q000276:immunology; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D007371:Interferon-gamma / Q000097:blood; D015847:Interleukin-4 / Q000097:blood; D007958:Leukocyte Count; D010976:Platelet Count; D013601:T-Lymphocytes / Q000187:drug effects / Q000276:immunology*
D015703:Antigens, CD; D006684:HLA-DR Antigens; D007166:Immunosuppressive Agents; D015847:Interleukin-4; D007371:Interferon-gamma; D016572:Cyclosporine