title: Idiopathic CD4+ lymphocytopenia and juvenile laryngeal papillomatosis.
abstract: We report on an association of idiopathic CD4+ lymphocytopenia (ICL) and juvenile laryngeal papillomatosis (JLP) in a pediatric-aged patient. Because of a past medical history of recurrent lung infections and severe chickenpox in infancy, immunologic investigations were done at age 6 years. On several occasions, a CD4+lymphocyte count of <300 cells/mm3 was detected, supporting the diagnosis of ICL. During follow-up, both medical (interferon-alpha) and surgical treatments of JLP were only partially efficient. Our patient developed disseminated infection with Mycobacterium avium and died at 10 years of age. Human papillomavirus is an important pathogen in pediatric and adult patients with ICL. In pediatric patients with JLP who develop other unusually severe viral or opportunistic infections, immunological investigations should be considered.
authors.affiliation: Pediatric Clinic and Pediatric Surgery Clinic, Mother and Child Health Institute, Belgrade, Serbia and Montenegro. bg.pasic@eunet.yu
authors.forename: Srdjan
authors.initials: S
authors.lastname: Pasic
authors.forename: Predrag
authors.initials: P
authors.lastname: Minic
authors.forename: Slobodan
authors.initials: S
authors.lastname: Dzudovic
authors.forename: Aleksandra
authors.initials: A
authors.lastname: Minic
authors.forename: Bojana
authors.initials: B
authors.lastname: Slavkovic
mesh_terms: D000914:Antibodies, Viral / Q000097:blood; D000995:Antitubercular Agents / Q000627:therapeutic use; D018791:CD4 Lymphocyte Count; D002644:Chickenpox / Q000097:blood / Q000150:complications / Q000276:immunology; D002648:Child; D002675:Child, Preschool; D017809:Fatal Outcome; D014645:Herpesvirus 3, Human / Q000276:immunology; D006801:Humans; D007223:Infant; D016898:Interferon-alpha / Q000627:therapeutic use; D007822:Laryngeal Neoplasms / Q000150:complications* / Q000601:surgery; D008297:Male; D015269:Mycobacterium avium Complex / Q000302:isolation & purification; D015270:Mycobacterium avium-intracellulare Infection / Q000188:drug therapy / Q000209:etiology / Q000382:microbiology; D010212:Papilloma / Q000150:complications* / Q000601:surgery; D010372:Pediatrics / Q000379:methods*; D018344:T-Lymphocytopenia, Idiopathic CD4-Positive / Q000175:diagnosis / Q000188:drug therapy / Q000276:immunology*
chemical_list: D000914:Antibodies, Viral; D000995:Antitubercular Agents; D016898:Interferon-alpha