[CIS PIDD] [cis-pidd] T cell lymphopenia/cryptococcal meningitis

[CIS-PIDD]

I agree with Kate, 
we also had 3 adult patients with IL7 deficiency (not receptor, ligand; Horev et al JAAD 2015) who presented with T cell lymphopenia (but not zero and more on the CD4 side) and cryptococcal meningitis, all of them had additional verrucosis, any sign of warts?
Happy to test serum if wished for.

best regards

klaus


Prof. Dr. med. Klaus Warnatz

MEDICAL CENTER – UNIVERSITY OF FREIBURG
Center for Chronic Immunodeficiency – CCI
Department of Rheumatology and Clinical Immunology

Breisacher Str. 117, 79106 Freiburg, Germany
Tel. +49 761 270 77640 / FAX -71000 / Pager 12-7100
klaus.warnatz at uniklinik-freiburg.de

www.uniklinik-freiburg.de/cci


________________________________________
Von: CIS-PIDD <cis-pidd at lists.clinimmsoc.org>
Gesendet: Dienstag, 6. Oktober 2015 12:33
An: CIS-PIDD
Betreff: Re: [cis-pidd] T cell lymphopenia/cryptococcal meningitis

I think with ALL T cells being low it is more likely to be a late onset SCID-like process.  I know it seems crazy at this age, but it does happen.  Rare for autoantibodies to attack all T cells and to get them to zero.


Kate Sullivan, MD PhD
Wallace Chair
Chief of Allergy Immunology
ARC 1216 CHOP
3615 Civic Center Blvd.
Philadelphia, PA 19104
(p) 215-590-1697
(f) 267-426-0363



> On Oct 5, 2015, at 9:28 PM, CIS-PIDD <cis-pidd at lists.clinimmsoc.org> wrote:
>
> Posting on behalf of Larry Borish <lb4m at virginia.edu>:
>
> 52 previously completely healthy M.  Presents to hospital with cryptococcus meningitis.  CD4’s are 0.  No big surprise there.  But CD8s are also 0.  CD3s are 0.  CD19/CD20 and IG’s all normal.  NKs slightly low.  Chest CT is not remarkable.  No thymoma and no lymphadenopathy.  His bone marrow normal, except for absence of CD3, CD4, and CD8 cells.  But nothing to suggest lymphoma.
>
> I suspect autoimmune but can’t get my laboratory to do indirect IF.  Does anyone have any other ideas or know of a lab who can screen for autoantibodies?
>
> Larry Borish, M.D.
> Professor of Medicine
> Asthma and Allergic Disease Center
> University of Virginia
> Charlottesville, VA 22908
> (434) 243-6570
> lb4m at virginia.edu
>
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