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PubMedDate not supplied

Clinical presentation of tuberculosis in patients with AIDS: an Indian experience.

A retrospective series of 25 patients with AIDS and tuberculosis is presented. Their clinical presentation, absolute lymphocyte count, CD4+ and CD8+ lymphocyte counts, treatment details and outcome are detailed. Commonest method of acquiring HIV infection was through heterosexual contact (10 of the 25; 40%) and blood transfusion (10 of the 25; 40%). More than 50% of the patients (14 of the 25) had extrapulmonary tuberculosis. Eighteen of the 19 patients for whom values were available had CD4+ lymphocyte count < 200/mm3. Four of the 18 patients for whom follow-up details were available died.

AIDS-Related Opportunistic Infections↗

PubMed1982

A quantitative ultrastructural study of peripheral blood lymphocytes containing parallel tubular arrays in Epstein-Barr virus and cytomegalovirus mononucleosis.

In the normal peripheral circulation there exists a subpopulation of lymphocytes that is ultrastructurally distinct. This lymphocyte is identified with the electron microscope by the presence of cytoplasmic microtubulelike inclusions called parallel tubular arrays (PTAs) and contains Fc-receptors for cytophilic antibody. In this study, lymphocytes containing PTAs (PTA-lymphocytes) were quantitated from serial peripheral blood specimens obtained from two patients with Epstein-Barr virus (EBV) mononucleosis and two patients with cytomegalovirus (CMV) mononucleosis. These data were then correlated with the clinical state of the patient. It was determined that both the percentage and absolute number of PTA-lymphocytes were highest during the acute phase of the illness. In follow-up specimens, three of the four patients' absolute lymphocyte count fell to within normal limits before the absolute PTA-lymphocyte count. In one patient, the absolute PTA-lymphocyte count was significantly elevated 13 months after the initial clinic visit. Although the PTA-lymphocyte count was highest during the acute phase of the illness, there was no consistent correlation with the clinical state of the patient during follow-up. The estimation of absolute PTA-lymphocyte counts was determined to be valid after a morphometric analysis of the cellular areas occupied by PTAs during the acute and convalescent phases of the disease revealed no statistical differences. Electron microscopy was also performed on the peripheral blood of a patient with syphilis. Although a hematologic workup of this patient during the acute phase of his illness revealed a large number of atypical lymphocytes, electron-microscopic examination of the same specimen revealed both a normal number and a normal percentage of PTA-lymphocytes. The immunologic role of this ultrastructurally distinct third population (non-T, non-B) of lymphocytes, or "killer cells," in the course of infectious mononucleosis is discussed.

Acute Disease↗

PubMed2006

Pneumocystis carinii pneumonia in patients with connective tissue disease.

BACKGROUND: Although the association of Pneumocystis carinii pneumonia (PCP) with connective tissue disease (CTD) has been noted for a long time, there are few series reported. OBJECTIVE: The objective of this study was to describe clinical features and prognosis of PCP infections in patients with CTD in China. METHODS: We retrospectively reviewed the characteristics, clinical features, and prognosis of PCP in patients with CTD in a single hospital. RESULTS: A total of 7 cases were reviewed (systemic lupus erythematosus n = 2, microscopic polyangiitis n = 2, dermatomyositis n = 2, polymyositis n = 1). Eighty-six percent of patients developed PCP within 3 months of the diagnosis of CTD. All patients were receiving daily glucocorticoid therapy and cytotoxic drugs before the diagnosis of PCP. Most patients had fever, progressive dyspnea, and dry cough at onset of PCP. The mean duration of symptoms before PCP diagnosis was 7 days. Absolute lymphocyte counts ranged from 126 to 528/microL. The CD4 lymphocyte counts of all patients were 87 +/- 78/microL. One patient was diagnosed by induced sputum; 6 patients were diagnosed by bronchoalveolar lavage fluid. Complicating fungal infection was found in 4 of 7 patients at the time of diagnosis of PCP. All patients were treated by trimethoprim-sulfamethoxazole and corticosteroids. Six (86%) patients died. The mean duration of the time from diagnosis to death was 14 +/- 4 days. CONCLUSIONS: Our results suggest that PCP is an uncommon and fatal opportunistic infection in patients with CTD. When patients with CTD who are receiving immunosuppressive therapy have low lymphocyte counts and/or CD4 lymphocyte counts less than 250/microL develop fever, dry cough, dyspnea, and chest radiography shows diffuse interstitial infiltrate, the diagnosis of PCP should be highly suspected. Induced sputum or BAL must be quickly performed to confirm diagnosis. Further study is needed as to whether earlier treatment will improve prognoses or whether patients with CTD with low CD4 counts should receive PCP prophylaxis.

Adult↗

PubMed2006

Cyclosporine lymphocyte maximum level monitoring in de novo kidney transplant patients: a prospective study.

OBJECTIVES: To determine prospectively the temporal variations of cyclosporine-A lymphocyte maximum level, whole blood maximum concentration, and total lymphocyte count in patients with de novo kidney transplantation. MATERIALS AND METHODS: Lymphocyte maximum level, whole blood maximum concentration, and total lymphocyte count were prospectively measured in 35 patients at 1, 2, and 3 months after kidney transplantation. Two groups--a biopsy-proven acute rejection group (REJ+) and a rejection-free group (REJ-)--were compared. RESULTS: Both groups had similar lymphocyte maximum levels, whole blood maximum concentrations, and total lymphocyte counts at the first month after transplantation. REJ+ patients had significantly lower lymphocyte maximum levels at 2 and 3 months (59+/-34 and 33+/-9 pg/Lc) and higher total lymphocyte counts (0.00204+/-0.00078x10(9)/L and 0.00203+/-0.00022x10(9)/L) when compared with their REJ- counterparts (87+/-56 and 63+/-30 pg/Lc, P<.05 and P<.007) and (0.00137+/-0.00074x10(9)/L and 0.0015+/-0.0006x10(9)/L, P<.02 and P<.003) respectively. Whole blood maximum concentrations were significantly higher in patients in the REJ+ group (2050+/-623 vs 1414+/-536 ng/mL, P<.02) at 2 months. At 3 months, the 2 groups were comparable (1158+/-340 vs 1365+/-525 ng/mL, P=NS). CONCLUSIONS: These results suggest that acute rejection is associated with a relatively low cyclosporine- A lymphocyte maximum level and high total lymphocyte count in the early posttransplant period. Cyclosporine-A whole blood maximum concentration failed to correlate with clinical outcome. Cyclosporine-A lymphocyte maximum level seems to offer a more reliable alternative than does whole blood maximum concentration for cyclosporine-A monitoring in patients with kidney transplantation.

Adult↗

PubMed1974

The small intestine in dermatitis herpetiformis.

Small intestinal biopsies from 43 patients with dermatitis herpetiformis have been studied. The diagnosis of dermatitis herpetiformis was made on clinical and histological criteria and the presence of IgA deposits in the uninvolved skin. The macroscopic appearance of the intestinal biopsy was flat in 13, convoluted in 10, leaves only in eight, and fingers and leaves in 12. Twenty small intestinal biopsies from patients who did not have dermatitis herpetiformis or gastrointestinal disorder showed leaves only in three and fingers and leaves in 17. The mean total lymphocyte count per 1000 epithelial cells for this control group was 159 +/- SE 13; for the dermatitis herpetiformis patients with flat biopsies it was 464 +/- SE 27; for the convoluted biopsies 365 +/- SE 59; for leaves only 535 +/- SE 39; and for the fingers and leaves biopsies 301 +/- SE 31. The counts for all four groups are significantly greater than the control group (P < 0.001). Three of the 43 patients with dermatitis herpetiformis had lymphocyte counts below 200 per 1000 epithelial cells, and four of our controls had counts greater than 200 but none above 300. In the control group the mean counts for lymphocytes per 1000 epithelial cells in the basal position of the intestinal epithelium was 79 +/- SE 8; in the dermatitis herpetiformis flat biopsies it was 89 +/- SE 11; for the convoluted biopsies 93 +/- SE 12; for the leaves only biopsies 121 +/- SE 18 and for the fingers and leaves 98 +/- SE 13. However, the mean lymphocyte count in the perinuclear position was 81 +/- SE 7 for the controls, 362 +/- SE 23 for the flat dermatitis herpetiformis biopsies; 251 +/- SE 46 for the convoluted specimens; 402 +/- SE 43 for the leaves only specimens, and 195 +/- SE 25 for the fingers and leaves biopsies. The mean lymphocyte count for the supranuclear position was 0.55 +/- SE 0.22 for the control group; 13.7 +/- SE 2.3 for the flat dermatitis herpetiformis biopsies; 20.0 +/- SE 6.9 for the convoluted biopsies; 14.5 +/- SE 3.3 for the leaves only biopsies; and 8.3 +/- SE 2.6 for the fingers and leaves biopsies. Thus in gluten-sensitive enteropathy the increase in lymphocytes in the intestinal epithelium is in the perinuclear and supranuclear position. The ratio of basal lymphocytes to peri- and supranuclear lymphocytes appears to be 1:1 in normal intestinal epithelium, but approximately 1:4 in the gluten-sensitive enteropathy of dermatitis herpetiformis.

Adult↗

PubMed1997

The influence of drug use patterns on the rate of CD4+ lymphocyte decline among HIV-1-infected injecting drug users.

OBJECTIVES: To assess the relationship between various injecting drug use patterns and the rate of CD4+ lymphocyte decline in HIV-1-infected injecting drug users in Baltimore, Maryland, USA. METHODS: A cohort of 605 HIV-1-infected injecting drug users was recruited between 1988 and early 1989 in East Baltimore using extensive community outreach techniques. The participants were interviewed semi-annually to collect information on drug use practices. The outcome measure of interest was the rate of CD4+ lymphocyte decline between pairs of CD4+ lymphocyte counts. A mixed model was used to evaluate the relationship between the change in CD4+ lymphocyte count per month and previous CD4+ lymphocyte count and various drug use variables. RESULTS: The 605 HIV-infected injecting drug users had a median initial CD4+ lymphocyte count of 513 cells x 10(6)/l. Using 3209 paired observations, the mean change in CD4+ lymphocyte count was -3.2 cells x 10(6)/l per month. The rate of decline was higher in those with a higher level of CD4+ lymphocytes (P < 0.01) and length of drug use (P < 0.01), but did not vary by injection frequency or injection intensity of specific drug types. Although animal studies have suggested that the pattern of drug administration (continuous versus intermittent) and episodes of withdrawal or overdose might impact the rate of CD4+ lymphocyte decline, this was not observed in the present study. CONCLUSION: Patterns of injecting drug use, based on self-report, were not associated with the rate of decline in CD4+ lymphocytes.

Acquired Immunodeficiency Syndrome↗

PubMed1995

Response to influenza immunisation in asymptomatic HIV infected men.

OBJECTIVE: This study aimed to determine if patients with HIV infection can develop a significant antibody response to influenza immunisation, and whether such immunisation is detrimental to the progression of their HIV illness. DESIGN: Prospective, non-randomised study. METHODS: The titres of antibody response to influenza immunisation were determined in 44 asymptomatic HIV positive men and compared with 16 HIV presumed seronegative controls. The magnitude of response were correlated with patients' CD4 lymphocyte counts. The rate of CD4 lymphocyte count decline over a median of 12 months before and after immunisation were also evaluated. RESULTS: Thirty-two of the 44 HIV positive subjects (73%) were able to mount a four-fold or greater response to at least one of the influenza strains, and 14 of them (32%) did so to all four strains. In comparison, 15 of the 16 controls (93.5%) had a four-fold or greater response to at least one, and six of them (38%) to all influenza strains, which was not significantly different from the HIV positive group. The magnitude of increase in antibody titre was not significantly different between the two groups either. CD4 lymphocyte count change for a median of 12 months after immunisation was not different from a median of 12 months before immunisation. CONCLUSIONS: Asymptomatic HIV infected patients are able to mount antibody response to influenza immunisation, which appears to be safe in respect to HIV illness progression in the short term.

Adolescent↗

PubMed1997

[Polyclonal lymphocytosis with binucleated lymphocytes. Morphological, immunological, cytogenetic and molecular analysis in 15 cases].

OBJECTIVES: Describe the clinical, immunological, cytogenetic and molecular aspects of polyclonal lymphocytosis with binucleated peripheral lymphocytes in order to ascertain the therapeutic consequences. PATIENTS AND METHODS: Fifteen patients, 13 women, 2 men, with a total lymphocyte count persistently above 4 x 10(9)/l at successive counts and binucleated lymphocytes on blood smears were studied. RESULTS: The syndrome is easily recognized at careful examination of blood smears which show binucleated lymphocytes and lymphoid cells with heterogeneous morphology. The lymphocytosis is polyclonal. The clinical situation remains stable without treatment despite cytogenetic clonality which contrasts with molecular polyclonality. DISCUSSION: Polyclonal lymphocytosis with binucleated lymphocytes is a clinical entity characterized by 1) nearly exclusive female predominance, mainly in young smokers; 2) lymphocyte counts above 4 x 10(9)/l which persist (> 6 months), are unchanged over time and fortuitously discovered; 3) lymphocytosis with binucleated lymphocytes on blood smears; 4) polyclonal lymphocytosis; 5) increased polyclonal serum IgM; and 6) recurrent cytogenetic anomalies with an isochromosome supenumerary marker, e.g. +i (3q). The etiology remains unknown: the role of smoking genetic predisposition or viral factors remains to be determined.

Adult↗

PubMed1984

Ophthalmologic findings in acquired immune deficiency syndrome (AIDS).

Forty-one homosexually active men had ophthalmologic and immunologic evaluations. Four of eight with acquired immune deficiency syndrome (AIDS) had abnormal ocular findings that included cotton-wool spots, retinal hemorrhages, cytomegalovirus, retinitis and conjunctivitis due to cytomegalovirus, and keratoconjunctivitis sicca. The other four patients with AIDS and 33 homosexual male controls had normal ocular examinations. Patients with AIDS and abnormal eye findings had a notably lower total leukocyte count, absolute lymphocyte count, percentage T-helper lymphocytes, helper-suppressor lymphocyte ratio, hematocrit level, and platelet count than patients with AIDS and normal results on eye examination or controls. All patients with AIDS and abnormal eye examination results died; the four other patients with AIDS and normal eye findings remain alive. These observations suggest that ophthalmologic abnormalities are common in patients with AIDS, are associated with severe immunoregulatory abnormalities, and carry a poor prognosis.

Acquired Immunodeficiency Syndrome↗

PubMed2003

Sarcoidosis following HIV infection: evidence for CD4+ lymphocyte dependence.

BACKGROUND: The chronic granulomatous inflammation of sarcoidosis has been hypothesized to depend on the CD4+ T-helper lymphocyte. HIV infection, which depletes these cells, has been reported to attenuate the manifestations of sarcoidosis. STUDY OBJECTIVES: We asked whether the development of symptomatic sarcoidosis in the context of preexisting HIV infection was dependent on the CD4+ lymphocyte count. DESIGN: We performed a retrospective standardized chart review of all patients who developed granulomatous inflammation following HIV infection at an urban academic referral center. MEASUREMENTS: We identified seven patients with sarcoidosis within this cohort and compared their CD4+ lymphocyte count to that in a cohort of 16 patients in whom similar granulomatous inflammation was found but who did not have sarcoidosis. We then compared our cases to all reported cases using a systematic literature review. RESULTS: The CD4+ lymphocyte count was > 200 cells/ microL in all of our patients with HIV infection when they developed subsequent sarcoidosis. In contrast, specific etiologies for granulomatous inflammation were found in all 10 HIV-infected patients who presented with granulomatous inflammation and a CD4+ lymphocyte count of < 200 cells/ microL, with infectious etiologies found in 8 patients. Similarly, there was relative preservation of the CD4+ lymphocyte count in previously reported cases, with 14 of 19 patients (74%) having an absolute CD4+ lymphocyte count of > 200 cells/ microL. CONCLUSIONS: We conclude that the development of the chronic granulomatous inflammation of sarcoidosis appears to depend on the preservation or restoration of the peripheral CD4+ lymphocyte count and that in most cases the CD4+ lymphocyte count exceeds 200 cells/ microL. Furthermore, alternative specific etiologies of granulomatous inflammation are generally identifiable in HIV-infected patients with peripheral CD4+ lymphocyte counts of < 200 cells/ microL.

AIDS-Related Opportunistic Infections↗

PubMed1994

Early diagnosis of severe combined immunodeficiency syndrome.

Infants with severe combined immunodeficiency syndrome (SCIDS) have a greatly improved prognosis if diagnosed and treated before they develop overwhelming infection. Clinical and laboratory data on 45 patients with SCIDS were retrospectively reviewed to assess the value of absolute lymphocyte counts in making an early diagnosis. Ninety infants matched for age, sex, and presenting symptoms were used as controls. Thirteen (29%) infants with SCIDS were diagnosed at birth as previous siblings had been affected; 32 (71%) were diagnosed after the development of symptoms. Eighteen (56%) of these remained undiagnosed until after 6 months of age. The first symptoms occurred at a median of 5 weeks (range 1 day to 8 months) and the first admission to hospital was at 4 months (range 1 week to 16 months). Symptoms included respiratory infection (91%), vomiting and diarrhoea (81%), failure to thrive (88%), candidiasis (50%), and skin lesions (28%). The mean lymphocyte count was 1.71 x 10(9)/l compared with 7.2 x 10(9)/l in controls. Excluding one child with Omenn's syndrome (lymphocyte count 23.3 x 10(9)/l, all symptomatic infants with SCIDS had lymphocyte counts less than 2.8 x 10(9)/l at presentation. The median delay between the first abnormal lymphocyte count and diagnosis was seven weeks (range one day to 13 months). Twenty eight (88%) of 32 infants would have been diagnosed before 6 months of age if investigated after the first low lymphocyte count. These data indicate that low lymphocyte counts are predictive of SCIDS. Paediatricians are urged to pay attention to the absolute lymphocyte counts in all infants in whom a full blood count is performed. Those with lymphocyte counts persistently less than 2.8 x 10(9)l should be investigated for SCIDS.

Age of Onset↗

PubMedDate not supplied

Prognostic factors in colorectal carcinoma: significance of peripheral T lymphocytes.

An analysis was made of a consecutive series of 150 patients with colorectal carcinoma treated in Shinkokura Hospital from 1973 to 1987. The prognostic factors included resection or nonresection, the year of resection, macroscopic type, histologic differentiation, venous and lymphatic invasion, Dukes' stage, serum carcinoembryonic antigen (CEA) level and peripheral T lymphocyte count. CEA, T lymphocytes and B lymphocytes were studied clinically and immunohistochemically. Clinical and immunohistochemical data on T lymphocytes were obtainable for 24 patients. Seventeen of the 24 were of more than 1000/mm3 of preoperative peripheral T lymphocytes and consisted of seven dense, six moderate and four slight immunohistochemical types, while the remaining seven were of less than 1000/mm3 of T lymphocytes and comprised one dense, two moderate and four slight ones. One-year survival rates of slight (8), moderate (8) and dense (8) types were 60%, 90% and 94%, respectively, and three-year survivals were 42%, 57%, and 76% (p less than 0.05). We suggest that the immunohistochemical demonstration of T lymphocytes relates to the peripheral T lymphocyte count and is one sign of an early, good prognosis for patient with colorectal carcinoma.

Carcinoembryonic Antigen↗

PubMed1989

[Effect of treatment with recombinant interferon alfa on natural killer activity in patients with chronic type B lymphatic leukemia].

The role played by alpha interferon (alpha-IFN) in the treatment of B-type chronic lymphocytic leukaemia (B-CLL) has been studied by different authors. Despite the inconclusiveness of the results, alpha-IFN seems to be more effective in those patients with low tumour burden (early stages) who have been previously untreated. Although the mechanism of action of alpha-IFN is not wholly understood, it is known that this agent is a strong stimulant of the natural killer lymphocytes (NK). NK activity has been found decreased in B-CLL. In the present work the effect of alpha-IFN on NK activity was studied in 9 previously untreated B-CLL patients in stage A, who received chlorambucil (CLB) followed by alpha-IFN for at least 4 months. The disease stage did not change in most of the patients during alkylating or IFN therapy. CLB failed to increase NK activity, although it diminished the lymphocyte count. Although the lymphocyte count of the patients treated with alpha-IFN was not reduced beyond the values attained by CLB, NK activity reached normal values in 5 of the 7 patients in whom this was low, and kept within normal ranges in the two patients with normal NK activity. The number of CD57+ lymphocytes (this being the antigen present in NK cells) increased after alpha-IFN treatment, without any changes in the remaining T-lymphocyte (CD2, CD4 and CD8) and NK (CD16 and CD11b) subpopulations. These results show that alpha-IFN enhances NK activity in vivo.

Adult↗

PubMed1992

Natural history of advanced HIV disease in patients treated with zidovudine. The Zidovudine Epidemiology Study Group.

OBJECTIVE: To describe the natural history of advanced HIV disease in patients treated with zidovudine. DESIGN: Longitudinal, observational study. SETTING: Twelve academic and community-based sites. PATIENTS, PARTICIPANTS: Eight hundred and sixty-three patients with AIDS or AIDS-related complex (ARC) with a CD4+ lymphocyte count less than 250 x 10(6)/l, who first received zidovudine between 15 April 1987 and 14 April 1988. MAIN OUTCOME MEASURES: Survival, progression to AIDS and first development of specific opportunistic illness. RESULTS: Median survival after initiation of zidovudine therapy ranged from greater than 900 days in patients with a baseline CD4+ lymphocyte count greater than or equal to 150 x 10(6)/l to 560 days in patients with a CD4+ lymphocyte count less than 50 x 10(6)/1. Other factors associated significantly with poorer survival were diagnosis of AIDS (versus ARC), baseline age greater than or equal to 40 years, hematocrit less than 35%, and diminished functional status. In patients with ARC at enrollment, median time of progression to AIDS ranged from 810 days in patients with a CD4+ lymphocyte count greater than or equal to 150 x 10(6)/l to 310 days in patients with a CD4+ lymphocyte count less than 50 x 10(6)/l. Rates of development of specific opportunistic infections or neoplasms and HIV encephalopathy were determined for different baseline CD4+ lymphocyte count ranges. Myelosuppression was significantly more common in patients with CD4+ lymphocyte counts greater than or equal to 100 x 10(6)/l. Sixty-five per cent of patients with a CD4+ lymphocyte count greater than or equal to 100 x 10(6)/l and 51% with a CD4+ lymphocyte count less than 100 x 10(6)/l continued to receive zidovudine 2 years after starting therapy. CONCLUSIONS: We describe the natural history of a cohort of patients treated with zidovudine for advanced HIV disease. These CD4+ lymphocyte count-stratified estimates of disease progression should provide prognostic information useful in the clinical management of advanced disease and the design of future studies.

AIDS-Related Complex↗

PubMed1990

Timing of diagnosis and lymphocyte accumulation patterns in chronic lymphocytic leukemia: analysis of their clinical significance.

In order to evaluate the clinical significance of the timing of diagnosis in chronic lymphocytic leukemia (CLL), we studied the diagnostic latency (DL), a variable related both to lymphocyte count and to lymphocyte doubling time (LDT), which points out the interval between the date of CLL diagnosis and the time at which it could have been made (lymphocyte count in peripheral blood of at least 5.0 x 10(9)/l). In two different series accounting for 221 previously untreated CLL patients the trends of the DL tended to decrease as the risk increased. In other words, the more advanced the clinical stage the shorter the DL. On the other hand, the values of lymphocyte accumulation rate (LAR), which defines the speed at which the number of lymphocytes increases over the time, were significantly lower in earlier stages of disease. Both DL and LAR had a significant impact on survival when investigated by means of univariate analysis. In a Cox's regression analysis applied to a training set of 122 patients, the combination of international clinical stages, LAR and age had the strongest value in predicting survival. The resulting model was validated in an independent subset of 99 patients (test-set cases) leading to a classification of patients into low-, intermediate-, and high-risk groups with 5-year survival rates of 89%, 31% and 8%, respectively, and with distinctively different annual mortality rates (p less than 0.001). Finally, when multivariate analysis was applied to study disease progression, LAR was the first variable to enter the regression model (p = 0.0001).

Humans↗

PubMed1998

Diarrhea and Clostridium difficile infection in Latin American patients with AIDS. Working Group on AIDS in Peru.

Diarrhea and wasting are among the most debilitating and deadly manifestations of AIDS, yet only limited information is available regarding the etiology, clinical consequences, and immunologic effects of infection with diarrheal agents. Peruvian AIDS patients presenting with and without diarrhea were followed prospectively to examine the relations among diarrheal pathogens, clinical presentations, CD4 lymphocyte count, weight loss, and survival. Patients with chronic diarrhea had lower CD4 lymphocyte counts (P = .001) and lost more weight (P < .001). Weight loss and a decreased CD4 lymphocyte count were associated with increased mortality (P = .011 and P = .003, respectively). Mean CD4 lymphocyte count varied significantly by diarrheal agent. Clostridium difficile was the most prevalent pathogen and was associated with significantly increased mortality before and after adjustment for coinfection, length of follow-up, CD4 lymphocyte count, and weight loss (P = .006). C. difficile may be a more important and more prevalent etiologic agent in AIDS than previously recognized and may represent a preventable cause of death in patients with immunosuppression.

AIDS-Related Opportunistic Infections↗

PubMed1990

[Lymphocyte-mediated immunological tests].

Two major types of immune response are present in the body; specific humoral antibody response and specific cell-mediated immune response. Lymphocytes play the major role in cell-mediated immune response, and also control the humoral antibody response. Lymphocyte functions are measured by various laboratory tests, including (1) peripheral lymphocyte count and morphology, (2) lymphocyte surface markers, (3) lymphocyte function tests with lymphocyte culture, (4) histopathological findings of the immune organs such as thymus, lymph nodes, intestinal lymphoid tissue and palatine tonsils. In routine practice, peripheral lymphocyte count and morphology is most commonly used, and then lymphocyte surface markers are measured by flow cytofluorometry using various monoclonal antibodies.

Antigens, Surface↗

PubMed2003

Pineal control of immune status and hematological changes in blood and bone marrow of male squirrels (Funambulus pennanti) during their reproductively active phase.

In addition to pineal control of reproduction in seasonal breeders, melatonin is also known to influence various immune parameters. In the present experiment, we assessed the effect of exogenous melatonin treatment on different hematological parameters of peripheral blood and bone marrow cells, together with histological observations of spleen and thymus blastogenic response and stimulation ratio, and hormonal assays (melatonin and testosterone) of Indian palm squirrel (Funambulus pennanti) during their reproductively active phase when endogenous melatonin levels are low. Daily subcutaneous injection of melatonin (25 microg/100 g body mass.) at 17.30-18.00 h to adult male squirrels for 60 consecutive days during May-June significantly increased the lymphocyte count of blood and bone marrow and the blastogenic response/percent stimulation ratio of spleen and thymus. Histological observation showed densely packed thymocytes and splenocytes. During this period, peripheral testosterone level was high and melatonin was low establishing an inverse relationship as noted earlier for this squirrel. In pinealectomized squirrels, decreased total leukocyte count and percent lymphocyte count in peripheral blood and bone marrow, along with a decreased cell density in spleen and thymus was observed histologically. Further, melatonin treatment of pinealectomized squirrels resulted in restoration of the immune parameters in line with a normal control level. We suggest that during the reproductively active period of male Indian palm squirrels the lymphoid organs were sensitive to melatonin; hence, the exogenous melatonin treatment had an immuno-enhancing effect.

Animals↗