Idiopathic CD4 Lymphocytopenia: Spectrum of opportunistic infections, malignancies, and autoimmune diseases

Idiopathic CD4 lymphocytopenia (ICL) was first defined in 1992 by the US Centers for Disease Control and Prevention (CDC) as the repeated presence of a CD4+ T lymphocyte count of fewer than 300 cells per cubic millimeter or of less than 20% of total T cells with no evidence of human immunodeficiency...

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Autores principales:	Dina S Ahmad, Mohammad Esmadi, William C Steinmann
Formato:	article
Lenguaje:	EN
Publicado:	Thieme Medical and Scientific Publishers Pvt. Ltd. 2013
Materias:	autoimmune diseases idiopathic cd4 lymphocytopenia lymphopenia opportunistic infections Medicine R
Acceso en línea:	https://doaj.org/article/358b6a4db52243f3a5fac7f14441550e
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spelling	oai:doaj.org-article:358b6a4db52243f3a5fac7f14441550e2021-12-02T17:59:10ZIdiopathic CD4 Lymphocytopenia: Spectrum of opportunistic infections, malignancies, and autoimmune diseases2231-07702249-446410.4103/2231-0770.114121https://doaj.org/article/358b6a4db52243f3a5fac7f14441550e2013-04-01T00:00:00Zhttp://www.thieme-connect.de/DOI/DOI?10.4103/2231-0770.114121https://doaj.org/toc/2231-0770https://doaj.org/toc/2249-4464Idiopathic CD4 lymphocytopenia (ICL) was first defined in 1992 by the US Centers for Disease Control and Prevention (CDC) as the repeated presence of a CD4+ T lymphocyte count of fewer than 300 cells per cubic millimeter or of less than 20% of total T cells with no evidence of human immunodeficiency virus (HIV) infection and no condition that might cause depressed CD4 counts. Most of our knowledge about ICL comes from scattered case reports. The aim of this study was to collect comprehensive data from the previously published cases to understand the characteristics of this rare condition. We searched the PubMed database and Science Direct for case reports since 1989 for Idiopathic CD4 lymphocytopenia cases. We found 258 cases diagnosed with ICL in 143 published papers. We collected data about age, sex, pathogens, site of infections, CD4 count, CD8 count, CD4:CD8 ratio, presence of HIV risk factors, malignancies, autoimmune diseases and whether the patients survived or died. The mean age at diagnosis of first opportunistic infection (or ICL if no opportunistic infection reported) was 40.7 ± 19.2 years (standard deviation), with a range of 1 to 85. One-sixty (62%) patients were males, 91 (35.2%) were females, and 7 (2.7%) patients were not identified whether males or females. Risk factors for HIV were documented in 36 (13.9%) patients. The mean initial CD4 count was 142.6 ± 103.9/mm 3 (standard deviation). The mean initial CD8 count was 295 ± 273.6/mm 3 (standard deviation). The mean initial CD4:CD8 ratio was 0.6 ± 0.7 (standard deviation). The mean lowest CD4 count was 115.4 ± 87.1/mm 3 (standard deviation). The majority of patients 226 (87.6%) had at least one infection. Cryptococcal infections were the most prevalent infections in ICL patients (26.6%), followed by mycobacterial infections (17%), candidal infections (16.2%), and VZV infections (13.1%). Malignancies were reported in 47 (18.1%) patients. Autoimmune diseases were reported in 37 (14.2%) patients.Dina S AhmadMohammad EsmadiWilliam C SteinmannThieme Medical and Scientific Publishers Pvt. Ltd.articleautoimmune diseasesidiopathic cd4 lymphocytopenialymphopeniaopportunistic infectionsMedicineRENAvicenna Journal of Medicine, Vol 03, Iss 02, Pp 37-47 (2013)
institution	DOAJ
collection	DOAJ
language	EN
topic	autoimmune diseases idiopathic cd4 lymphocytopenia lymphopenia opportunistic infections Medicine R
spellingShingle	autoimmune diseases idiopathic cd4 lymphocytopenia lymphopenia opportunistic infections Medicine R Dina S Ahmad Mohammad Esmadi William C Steinmann Idiopathic CD4 Lymphocytopenia: Spectrum of opportunistic infections, malignancies, and autoimmune diseases
description	Idiopathic CD4 lymphocytopenia (ICL) was first defined in 1992 by the US Centers for Disease Control and Prevention (CDC) as the repeated presence of a CD4+ T lymphocyte count of fewer than 300 cells per cubic millimeter or of less than 20% of total T cells with no evidence of human immunodeficiency virus (HIV) infection and no condition that might cause depressed CD4 counts. Most of our knowledge about ICL comes from scattered case reports. The aim of this study was to collect comprehensive data from the previously published cases to understand the characteristics of this rare condition. We searched the PubMed database and Science Direct for case reports since 1989 for Idiopathic CD4 lymphocytopenia cases. We found 258 cases diagnosed with ICL in 143 published papers. We collected data about age, sex, pathogens, site of infections, CD4 count, CD8 count, CD4:CD8 ratio, presence of HIV risk factors, malignancies, autoimmune diseases and whether the patients survived or died. The mean age at diagnosis of first opportunistic infection (or ICL if no opportunistic infection reported) was 40.7 ± 19.2 years (standard deviation), with a range of 1 to 85. One-sixty (62%) patients were males, 91 (35.2%) were females, and 7 (2.7%) patients were not identified whether males or females. Risk factors for HIV were documented in 36 (13.9%) patients. The mean initial CD4 count was 142.6 ± 103.9/mm 3 (standard deviation). The mean initial CD8 count was 295 ± 273.6/mm 3 (standard deviation). The mean initial CD4:CD8 ratio was 0.6 ± 0.7 (standard deviation). The mean lowest CD4 count was 115.4 ± 87.1/mm 3 (standard deviation). The majority of patients 226 (87.6%) had at least one infection. Cryptococcal infections were the most prevalent infections in ICL patients (26.6%), followed by mycobacterial infections (17%), candidal infections (16.2%), and VZV infections (13.1%). Malignancies were reported in 47 (18.1%) patients. Autoimmune diseases were reported in 37 (14.2%) patients.
format	article
author	Dina S Ahmad Mohammad Esmadi William C Steinmann
author_facet	Dina S Ahmad Mohammad Esmadi William C Steinmann
author_sort	Dina S Ahmad
title	Idiopathic CD4 Lymphocytopenia: Spectrum of opportunistic infections, malignancies, and autoimmune diseases
title_short	Idiopathic CD4 Lymphocytopenia: Spectrum of opportunistic infections, malignancies, and autoimmune diseases
title_full	Idiopathic CD4 Lymphocytopenia: Spectrum of opportunistic infections, malignancies, and autoimmune diseases
title_fullStr	Idiopathic CD4 Lymphocytopenia: Spectrum of opportunistic infections, malignancies, and autoimmune diseases
title_full_unstemmed	Idiopathic CD4 Lymphocytopenia: Spectrum of opportunistic infections, malignancies, and autoimmune diseases
title_sort	idiopathic cd4 lymphocytopenia: spectrum of opportunistic infections, malignancies, and autoimmune diseases
publisher	Thieme Medical and Scientific Publishers Pvt. Ltd.
publishDate	2013
url	https://doaj.org/article/358b6a4db52243f3a5fac7f14441550e
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Idiopathic CD4 Lymphocytopenia: Spectrum of opportunistic infections, malignancies, and autoimmune diseases

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