[CIS PIDD] [cis-pidd] Low CD*+ with restrictive lung disease.

[CIS-PIDD]

Dr Wiens,

you should check for MHC class I expression that is associated with especially CD8 lymphopenia and chronic lung disease.

Best, Fabian

Fabian Hauck, MD, PhD
Head of Immunodeficiency Unit and Immunological Diagnostics Laboratory
Consultant Hematologist/Oncologist
Dr. von Hauner Children’s Hospital
Klinikum der Universität München
Campus Innenstadt
Lindwurmstrasse 4, 80337 Munich
Phone: +49 (89) 4400-53931
Fax: +49 (89) 4400-53964
Email: fabian.hauck at med.uni-muenchen.de

The Klinikum der Universität München is an Institution under Public Law
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Von: CIS-PIDD [cis-pidd at lists.clinimmsoc.org]
Gesendet: Donnerstag, 23. Juni 2016 21:56
An: CIS-PIDD
Betreff: RE: [cis-pidd] Low CD*+ with restrictive lung disease.

Dr Wiens

Interpreting flow cytometry in autoimmune disease is difficult.  When I do look at patients with SLE their flow is very abnormal and I never know what to do with it.  I wouldn’t trust a single flow test.  Flow can be very abnormal in inflamed or infected patients, and is hard to interpret.

Low CD8 is seen in Zap70, although I know of no association with restrictive lung disease.

What is the chronic pneumonia?  Organism? BAL? Lung biopsy? Chronic viral infections?

Ig studies?  Other studies?

Best

James


James W. Verbsky M.D./Ph.D.
Associate Professor of Pediatrics and Microbiology
Medical Director, Clinical Immunology Research Laboratory
Medical Director, Clinical and Translational Research
Medical College of Wisconsin
Milwaukee, WI



From: CIS-PIDD [mailto:cis-pidd at lists.clinimmsoc.org]
Sent: Thursday, June 23, 2016 2:51 PM
To: CIS-PIDD
Subject: [cis-pidd] Low CD*+ with restrictive lung disease.

To all:
I have a 58 y.o. female with dyspnea and restrictive lung disease (FEV1 40%; FEV1/FVC 99%; FVC 44%) who I am referring to pulmonary for first time evaluation. She also has chronic pneumonia and I obtained lymphocyte panel which shows low CD8. I thought any restrictive lung disease due to scleroderma resulted in elevated CD8? Can this be correlated or am I dealing with 2 separate processes? Thanks in advance for all suggestions.





Component Results




Component

Value

Ref Range & Units

Status



CD3 T Lymphs (%)

67

60-87 %

Final



CD3 T Lymphs (Absolute)

920

690-2540 cumm

Final



CD4+/CD3+ (%)

60

31-60 %

Final



CD4+/CD3+ (Absolute)

827

410-1590 cumm

Final



CD8+/CD3+ (%)

7 (L)

13-41 %

Final



CD8+/CD3+ (Absolute)

91 (L)

190-1140 cumm

Final



CD4/CD8 Ratio

9.13 (H)

0.90-3.50

Final



CD19 B Lymphs (%)

11

6-25 %

Final



CD19 B Lymphs (Absolute)

156

90-660 cumm

Final



NK Cells (%)

18

5-27 %

Final



NK Cells (Absolute)

253

90-590 cumm

Final



Lynn A. Wiens, MD
Office: 918-495-2636
Cell: 918-550-1200
http://tulsaallergynews.com
[cid:image001.jpg at 01D1CD5F.7B3EB770]



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