[CIS PIDD] [cis-pidd] quick question

[Dr. Jan Rohr]

Dear Rafael,

I am not familiar with the gating strategy of your lab, but a  
reference range down to 15% CD45RA+ cells in a 22 months old child  
seems pretty low to me. In our lab the patient's value of 20% CD45RA  
would be considered a pathologically low number at this age and thus  
warrant further investigations. What is also somewhat odd is that the  
percentages of CD45RA+ and CD45RO+ cells do not add to 100% - what do  
the remaining cell express if they are neither positive for CD45RA nor  
for CD45RO ?

May be worth to take a close look at the FACS plots.

Kind regards,

Jan



Zitat von Rafael Firszt <Rafael.Firszt at hsc.utah.edu>:

>
>
> I have a 22 month old with persistently borderline -mildly low CD8 counts
> Clinically doing very well.  Very mild URI's only.  Developing   
> normally and growing well.
> Tolerated Live viral vaccines.
> He was initially identified by newborn screen with low TRECS
> His immune parameters are below.
> He has normal CD45RA
>
> Ref. Range
>
> Units
>
> 06/05/15
> 12:10 *
>
> 08/13/14
> 12:15 [https://help2-lp.co.ihc.com/ResultsReview/images/note.gif] *
>
> 05/07/14
> 12:20
>
> 01/21/14
> 16:40 [https://help2-lp.co.ihc.com/ResultsReview/images/note.gif]
>
> Test Status
>
> Final
>
> Final
>
> Final
>
> Final
>
> % CD4 [https://help2-lp.co.ihc.com/ResultsReview/images/infoTrans.gif]
>
> 31-54
>
> %
>
> 30 L
>
> 30 L
>
> * 24 L
>
> * 25 L
>
> CD4, Abs Count   
> [https://help2-lp.co.ihc.com/ResultsReview/images/infoTrans.gif]
>
> 1020-3600
>
> cells/uL
>
> 924 L
>
> 1096
>
> * 1002 L
>
> * 989 L
>
> % CD45RO [https://help2-lp.co.ihc.com/ResultsReview/images/infoTrans.gif]
>
> 5-30
>
> %
>
> 11
>
> 7
>
> * 6
>
> * 7
>
> Absolute CD45RO   
> [https://help2-lp.co.ihc.com/ResultsReview/images/infoTrans.gif]
>
> 50-1500
>
> cells/uL
>
> 299
>
> 239
>
> * 246
>
> * 263
>
> % CD45RA [https://help2-lp.co.ihc.com/ResultsReview/images/infoTrans.gif]
>
> 15-70
>
> %
>
> 20
>
> 24
>
> * 19
>
> * 20
>
> Absolute CD45RA   
> [https://help2-lp.co.ihc.com/ResultsReview/images/infoTrans.gif]
>
> 200-3400
>
> cells/uL
>
> 571
>
> 786
>
> * 810
>
> * 742
>
> CD4/CD8 Ratio   
> [https://help2-lp.co.ihc.com/ResultsReview/images/infoTrans.gif]
>
> 1.17-6.62
>
> ratio
>
> 3.00
>
> 3.33
>
> * 3.00
>
> * 3.12
>
> % CD8 [https://help2-lp.co.ihc.com/ResultsReview/images/infoTrans.gif]
>
> 16-38
>
> %
>
> 10 L
>
> 9 L
>
> * 8 L
>
> * 8 L
>
> Absolute CD8 [https://help2-lp.co.ihc.com/ResultsReview/images/infoTrans.gif]
>
> 570-2230
>
> cells/uL
>
> 292 L
>
> 339 L
>
> * 326 L
>
> * 329 L
>
> % CD3 [https://help2-lp.co.ihc.com/ResultsReview/images/infoTrans.gif]
>
> 53-81
>
> %
>
> 43 L
>
> 40 L
>
> * 34 L
>
> * 34 L
>
> Absolute CD3 [https://help2-lp.co.ihc.com/ResultsReview/images/infoTrans.gif]
>
> 1460-5440
>
> cells/uL
>
> 1316 L
>
> 1483
>
> * 1373 L
>
> * 1349 L
>
> % CD19 [https://help2-lp.co.ihc.com/ResultsReview/images/infoTrans.gif]
>
> 11-45
>
> %
>
> 46 H
>
> 47 H
>
> * 49 H
>
> * 51 H
>
> Absolute CD19   
> [https://help2-lp.co.ihc.com/ResultsReview/images/infoTrans.gif]
>
> 430-3300
>
> cells/uL
>
> 1381
>
> 1725
>
> * 2009
>
> * 2051
>
> % Natural Killer Cells   
> [https://help2-lp.co.ihc.com/ResultsReview/images/infoTrans.gif]
>
> 3-19
>
> %
>
> 9
>
> 11
>
> * 15
>
> * 13
>
> Absolute Natural Killer Cells   
> [https://help2-lp.co.ihc.com/ResultsReview/images/infoTrans.gif]
>
> 80-340
>
> cells/uL
>
> 288
>
> 403 H
>
> * 621 H
>
> * 538 H
>
>
>
> In addition, he appears to have normal MHC I expression and normal   
> NK function
>
> His IgG, M, A levels normal with very protective antibody titers.
> Normal lymphocyte mitogen assays.
>
>
> Should I be concerned?
>
>
> Thank you for your help.
>
> Rafael Firszt, MD
> University of Utah
>
>
>
>
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