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

[John Ziegler]

Dear Lynn

Is she hypergammaglobulinaemic? Have you done an HIV antibody test?

Cheers

John
___________________________
Professor John B. Ziegler, AM
Department of Immunology & Infectious Diseases
Sydney Children's Hospital
High St., Randwick NSW 2031
Australia
T: (02) 93821515
F: + 61 + 2 93821580
E: j.ziegler at unsw.edu.au<mailto:j.ziegler at unsw.edu.au>

On 5 Apr 2014, at 4:36 am, "Wiens, Lynn A MD" <lawiens at saintfrancis.com<mailto: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, Sinus disease, and Chronic Infections

http://tulsaallergynews.com

Office: 918-495-2636

Cell: 918-550-1200

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