[CIS PIDD] [cis-pidd] Patient question with low T & B cells

[Pere Soler Palacin]

hiv NEG? 

Pere Soler Palacín, MD, PhD. Pediatric Infectious Diseases and Immunodeficiencies Unit. Hospital Universitari Vall d'Hebron. Assistant Professor. Universitat Autònoma de Barcelona. 
Passeig de la Vall d'Hebron 119-129. 
08035 Barcelona. Spain. 
Tel: 0034934893140. Fax: 0034934893039. 
E-mail: psoler at vhebron.net ; 34660psp at comb.cat . Web: www.upiip.com . 


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----- Mensaje original ----- 
De: "Kenneth Paris" <kparis at lsuhsc.edu> 
Para: "CIS-PIDD" <cis-pidd at lists.clinimmsoc.org> 
Enviados: Viernes, 4 de Abril 2014 19:45:19 
Asunto: Re: [cis-pidd] Patient question with low T & B cells 



In that age group and with those symptoms, I would definitely consider a thymoma. She needs a chest CT. 


Ken Paris MD 
LSU Health Sciences Center 
New Orleans, LA 


Sent from my Verizon Wireless 4G LTE DROID 

"Wiens, Lynn A MD" <lawiens at saintfrancis.com> wrote: 




I have a 52 y/o white female who came to the office with oral thrush and persistent coughing. Her PFTs are unremarkable and her oral thrush resolved with Diflucan. As part of her evaluation, I obtained a lymphocyte panel which reveals the following (I did repeat the test to confirm) 

1. CD4+/CD3+ 46 (nl 410-1590) 

2. CD8+/CD3+ 1678 (nl 190-1120) 

3. CD4+/CD8+ 0.03 (0.90-3.5) 

4. CD19 B lymphs 20 (200-1300) 



She has surprisingly good antibody levels given her low CD19 cts. My question is: 

1. Other than oral thrush, she doesn’t have serious infections yet. Is there any additional evaluation you would recommend? 

2. Any other treatment at this time in addition to supportive care? I am quite concerned with that low CD4+ and CD 19 counts…how do I prevent the “time bomb?” 

Thanks to all! 



Lynn A. Wiens, MD 

Warren Clinic 

6160 South Yale Avenue Tulsa, OK 74136 

Specializing in the care of Allergy, Asthma, Sin us disease, and Chronic Infections 

http://tulsaallergynews.com 

Office: 918-495-2636 

Cell: 918-550-1200 

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