[CIS PIDD] [cis-pidd] 79yo with lymphopenia-associated mucositis

[CIS-PIDD]

Consider Mycoplasma pneumoniae - I am following an adolescent male with progressively worse episodes of Stevens-Johnson syndrome for three consecutive years associated with respiratory symptoms - the latest episode proven to be due to M. pneumoniae

From: CIS-PIDD [mailto:cis-pidd at lists.clinimmsoc.org]
Sent: Wednesday, August 03, 2016 2:02 PM
To: CIS-PIDD <cis-pidd at lyris.dundee.net>
Subject: Re: [cis-pidd] 79yo with lymphopenia-associated mucositis

Drug induced?
Yours, Bodo

****************************************
Univ.-Prof. Dr. med. B. Grimbacher

Scientific-Director
CCI-Center for Chronic Immunodeficiency
UNIVERSITÄTSKLINIKUM FREIBURG
Tel.: 0761 270-77731  Fax: -77744
Breisacherstraße 115, 79106 Freiburg
bodo.grimbacher at uniklinik-freiburg.de<mailto:bodo.grimbacher at uniklinik-freiburg.de>
www.uniklinik-freiburg.de/cci<http://www.uniklinik-freiburg.de/cci>

and

Consultant Immunologist
Institute of Immunity & Transplantation
Dept of Immunology
Royal Free Hospital
UNIVERSITY COLLEGE LONDON
Pond Street
London NW3 2QG
b.grimbacher at ucl.ac.uk<mailto:b.grimbacher at ucl.ac.uk>
www.centreforimmunodeficiency.com<http://www.centreforimmunodeficiency.com>

Von: CIS-PIDD <cis-pidd at lists.clinimmsoc.org<mailto:cis-pidd at lists.clinimmsoc.org>>
Antworten an: CIS-PIDD <cis-pidd at lyris.dundee.net<mailto:cis-pidd at lyris.dundee.net>>
Datum: Wednesday 3 August 2016 16:28
An: CIS-PIDD <cis-pidd at lyris.dundee.net<mailto:cis-pidd at lyris.dundee.net>>
Betreff: [cis-pidd] 79yo with lymphopenia-associated mucositis

Colleagues:

I was asked by an 'adult' ID physician about a 79yo man.  The patient is generally healthy.  However, once a year over the past 3 years he developed his 'annual' URI that was associated with HSV-negative oral mucositis.  During his latest episode his absolute lymphocyte count was 613/mcL and this resulted in T-lymphopenia.  B-cells and NK cell numbers were maintained.

Two months prior to this episode his lymphocyte count was 2219 on routine CBC.  Several weeks following resolution of the mucositis both lymphocyte count and subset analysis were normal.

Has anyone seen this process?  Any insights would be much appreciated.

Joe Church, MD
Children's Hospital Los Angeles





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