title: Detection of CD4(+) T-cell antibodies in a patient with idiopathic CD4 T lymphocytopenia and cryptococcal meningitis.
abstract: Idiopathic CD4(+) T lymphocytopenia (ICL) is defined as a CD4(+) T-cell count <0.3 x 10(9)/l or <20% of the total T-cell count on two occasions in the absence of any immunodeficiency disorder or therapy associated with reduced CD4(+) T-cell count. Although several mechanisms of ICL have been reported, the pathophysiology is still largely unknown. This case report describes a patient who presented with cryptococcal meningitis and was subsequently discovered to meet the criteria for ICL. Flow cytometric analysis of the patient's peripheral blood mononuclear cells revealed antibodies coating a much larger proportion of his CD4(+) T cells (33.61%) than the CD4(+) T cells of normal donors (3.94 +/- 1.77%). The reasons behind the development of these autoantibodies are explored.
authors.affiliation: Department of Internal Medicine, The University of Maryland Medical Center, Baltimore, MD 21201, USA. rsalit@earthlink.net
authors.forename: Rachel B
authors.initials: RB
authors.lastname: Salit
authors.forename: Kim G
authors.initials: KG
authors.lastname: Hankey
authors.forename: Rosemary
authors.initials: R
authors.lastname: Yi
authors.forename: Aaron P
authors.initials: AP
authors.lastname: Rapoport
authors.forename: Dean L
authors.initials: DL
authors.lastname: Mann
mesh_terms: D000368:Aged; D000911:Antibodies, Monoclonal / Q000097:blood; D001323:Autoantibodies / Q000097:blood*; D018791:CD4 Lymphocyte Count; D015496:CD4-Positive T-Lymphocytes / Q000276:immunology*; D005434:Flow Cytometry; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D008297:Male; D016919:Meningitis, Cryptococcal / Q000175:diagnosis / Q000276:immunology*; D011565:Psoriasis / Q000276:immunology; D018344:T-Lymphocytopenia, Idiopathic CD4-Positive / Q000276:immunology*
chemical_list: D000911:Antibodies, Monoclonal; D001323:Autoantibodies; D007074:Immunoglobulin G