[PAGID] lymphopenia

[Jung, Lawrence]

Richard,
I would check for evidence of autoimmunity such as lupus; for example, the neuropsychiatric illness may be CNS lupus and the leukocytopenia secondary to anti-neutrophil and anti-lymphocyte antibodies.
 
Larry Jung, M.D.
Children's National Medical Center
Washington, DC


________________________________

From: pagid-bounces at list.clinimmsoc.org on behalf of Richard L. Wasserman
Sent: Mon 1/5/2009 9:51 PM
To: PAGID
Subject: [PAGID] lymphopenia



A 13-year-old boy was referred to heme/onc for evaluation of leukopenia
of several years duration. He has no significant infections by history.
He has been treated for neuropsychiatic problems with trileptal,
welbutrin, Zoloft, Depakote and Concerta. At this time he only takes
Concerta and has not had any other medication in more than six months.

Physical examination was normal.

Over the past five years lymphocyte counts have ranged from 500 to 1200.
Most recently, B cell and NK cell number were normal; CD 4 was 300 and
CD8 250.

Does he need additional evaluation for this laboratory abnormality with
no clinical correlate?
Richard L. Wasserman, MD,PhD
Dallas


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