title: Role of Therapeutic Plasma Exchange in Treatment of Tumefactive Multiple Sclerosis-Associated Low CD4 and CD8 Levels.
abstract: We report a 35-year-old healthy male who developed central nervous system inflammatory demyelinating disease consistent with tumefactive multiple sclerosis. About 2 weeks after onset of symptoms and prior to initiation of therapy, the patient had lymphopenia and low CD4 and CD8 levels. His lymphocyte count was 400 cells/µl (850-3,900 cells/µl), CD4 was 193 cells/µl (490-1,740 cells/µl) and CD8 was 103 cells/µl (180-1,170 cells/µl). He was treated with intravenous methylprednisolone followed by therapeutic plasma exchange, the levels of CD4 and CD8 normalized, and ultimately, he recovered completely.
authors.affiliation: Neuroscience Institute, Saint Francis Medical Center, Trenton, N.J., USA.
authors.forename: Kristen
authors.initials: K
authors.lastname: Lew
authors.affiliation: Neuroscience Institute, Saint Francis Medical Center, Trenton, N.J., USA.
authors.forename: Nishith
authors.initials: N
authors.lastname: Mewada
authors.affiliation: Neuroscience Institute, Saint Francis Medical Center, Trenton, N.J., USA.
authors.forename: Sahana
authors.initials: S
authors.lastname: Ramanujam
authors.affiliation: Neuroscience Institute, Saint Francis Medical Center, Trenton, N.J., USA.
authors.forename: Bahareh
authors.initials: B
authors.lastname: Hassanzadeh
authors.affiliation: Division of Neuropathology, Department of Pathology, Rhode Island Hospital and the Warren Alpert Medical School of Brown University, Providence, R.I., USA.
authors.forename: John E
authors.initials: JE
authors.lastname: Donahue
authors.affiliation: The Neuro-Genetics Institute, Sharon Hill, Pa., USA.
authors.forename: Leema Reddy
authors.initials: LR
authors.lastname: Peddareddygari
authors.affiliation: Department of Pathology, Saint Francis Medical Center, Trenton, N.J., USA.
authors.forename: Robert
authors.initials: R
authors.lastname: Moser
authors.affiliation: Neuroscience Institute, Saint Francis Medical Center, Trenton, N.J., USA.
authors.forename: Charles
authors.initials: C
authors.lastname: Kososky
authors.affiliation: Neuroscience Institute, Saint Francis Medical Center, Trenton, N.J., USA.
authors.forename: Raji P
authors.initials: RP
authors.lastname: Grewal
keywords: Central nervous system; Inflammatory demyelinating disease; Lymphopenia; Plasma exchange