title: A marked decrease in CD4-positive lymphocytes at the onset of hepatitis in a patient with hepatitis-associated aplastic anemia.
abstract: A 10-year-old Japanese boy developed acute hepatitis with high levels of serum Torque teno virus DNA and marked lymphocytopenia, especially CD4 T-lymphocytopenia. Although the total lymphocyte counts rose as the patient recovered from hepatitis, this was largely because of a marked rise in CD8 cells. In contrast, CD4 cells recovered poorly, resulting in a further striking fall in the CD4/8 ratio. Two months later, the patient developed hepatitis-associated aplastic anemia. He was successfully treated with immunosuppressive therapy, which normalized the lymphocyte subset proportions. T-cell subsets analysis at the onset of hepatitis might be useful for predicting development of hepatitis-associated aplastic anemia.
authors.affiliation: Department of Pediatrics, Division of Virology, Jichi Medical University School of Medicine, Tochigi, Japan.
authors.forename: Takahiro
authors.initials: T
authors.lastname: Ikeda
authors.forename: Akira
authors.initials: A
authors.lastname: Morimoto
authors.forename: Sachie
authors.initials: S
authors.lastname: Nakamura
authors.forename: Koji
authors.initials: K
authors.lastname: Yokoyama
authors.forename: Tomomi
authors.initials: T
authors.lastname: Hayase
authors.forename: Yukiko
authors.initials: Y
authors.lastname: Oh
authors.forename: Yoshifumi
authors.initials: Y
authors.lastname: Kashii
authors.forename: Shigeru
authors.initials: S
authors.lastname: Yotsumoto
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Okamoto
authors.forename: Mariko
authors.initials: M
authors.lastname: Y Momoi
mesh_terms: D000208:Acute Disease; D000741:Anemia, Aplastic / Q000209:etiology*; D015496:CD4-Positive T-Lymphocytes / Q000276:immunology*; D002648:Child; D006525:Hepatitis, Viral, Human / Q000150:complications* / Q000276:immunology; D006801:Humans; D008231:Lymphopenia / Q000209:etiology*; D008297:Male; D022783:Torque teno virus / Q000302:isolation & purification*