Respir Case Rep. 2014; 3(1): 41-46 | DOI: 10.5505/respircase.2014.36744

Idiopathic CD4 T-Lymphocytopenia In A Patient With Disseminated Tuberculosis

Adil Zamani¹, Þebnem Yosunkaya¹, Ýsmail Reisli^2
1Department Of Chest Diseases Necmettin Erbakan University Meram Faculty Of Medicine, Konya
²Department Of Pediatrics Necmettin Erbakan University Meram Faculty Of Medicine, Konya

We present a 26-year-old male patient with a negative serological testing for human immunodeficiency virus, miliary tuberculosis with significant T-lymphocytopenia, multifocal skeletal involvements including the vertebrae and wrist, and in addition, right gluteal and bilateral iliopsoas abscesses. Mycobacterium tuberculosis was isolated from drainage fluid of abscesses and bronchial lavage cultures. The CD4 T-lymphocyte ratio, which had previously been determined to be 13% with flow cytometric analysis of peripheral blood, remained at low levels throughout the treatment period (14% to 20%). Although there was a slight increase in CD4 T-lymphocyte percentages (19% and 22%, respectively), and absolute CD4 T-lymphocyte counts (359/mm3 and 364/mm3, respectively) studied on the third and ninth months after discontinuation of treatment, it remained at low levels. The researchers observed rapid recovery in this case that underwent both percutaneous drainage, and chemotherapy treatment failure or relapse has not been observed in such a patient with immunodeficiency.

Keywords: gluteal abscess, iliopsoas abscess, lymphocytopenia, miliary tuberculosis, skeletal tuberculosis.

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Yaygýn Tüberkülozlu Bir Hastada Ýdiyopatik CD4 T-Lenfositopenisi

Adil Zamani¹, Þebnem Yosunkaya¹, Ýsmail Reisli^2
1Necmettin Erbakan Üniversitesi Meram Týp Fakültesi, Göðüs Hastalýklarý Ana Bilim Dalý, Konya
²Necmettin Erbakan Üniversitesi Meram Týp Fakültesi, Çocuk Hastalýklarý Ana Bilim Dalý, Konya

Yirmi altý yaþýnda serolojik olarak insan immun yetmezlik virusu negatif olan, belirgin T-lenfopeni ile miliyer tüberkülozu, vertebra ve elbileðini içeren birden çok odakta iskelet tutulumlarý ve ek olarak, sað gluteal ve bilateral iliopsoas abseleri olan bir erkek hasta sunuldu. Abselerden elde edilen drenaj materyali ve bronþ lavajý kültürlerinden Mikobakterium tüberkülosis izole edildi. Baþlangýçta, periferik kanda akým-sitometrik analiz ile %13 olarak tespit edilen CD4 T-lenfosit oraný, tedavi periyodu boyunca düþük seviyelerde kaldý (%14 ila %20). Her nekadar tedavi tamamlandýktan sonra 3üncü ve 9 uncu aylarda bakýlan CD4 T lenfosit oranlarý (sýrasýyla %19 ve %22) ve mutlak deðerleri (359/mm3 ve 364/mm3) hafif bir artýþ gösterse de, düþük seviyede kalmýþtýr. Hem kemoterapi hem de abseler için perkütan drenaj uygulanan böyle bir immunyetmezlikli hastada hýzlý bir düzelme olduðu ve relaps geliþmediði gözlendi.

Anahtar Kelimeler: gluteal abse, iliopsoas abse, lenfositopeni, milier tüberküloz, iskelet tüberkülozu.

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