Abstract
Importance of the issue: Idiopathic CD4 T lymphocytopenia is an unusual immune defect in which there is an unexplained deficit of CD4 T cells. This case presents a 39-year-old female patient, with CD4+ T lymphocytopenia, who was not infected with immunosuppressive viruses neither was she subjected to immunosuppressive therapies. Comments: While monitoring the patient, she was found to have very low serum ferritin and, after parenteral iron therapy, there were changes in CD4+ cell levels, indicating that, in this case, lymphocytopenia was secondary to sideropenia. The patient is being kept under strict control of serum iron and periodic immunological evaluation, and she has not showed any clinical and/or laboratory adverse events so far. It is known that iron deficiency is an important factor in the genesis of immunological changes that occur in patients with iron deficiency anemia. It is important to understand the effects of iron deficiency on the immune system due to its high prevalence worldwide. Moreover, it could also help to clarify several cases of idiopathic CD4 lymphocytopenia.
Highlights
Idiopathic CD4 lymphocytopenia (ICL) is a rare syndrome characterized by the total CD4+ cell count lower than 300 cells/μl, or lower than 20% of T lymphocytes, in adults
The differential diagnosis of ICL is broad[1] so it is made by exclusion and requires an extensive immunologic, hematologic, rheumatologic and infectious disease workup, as well as follow-up testing to confirm the persistence of lymphocytopenia
Despite twenty years of research, ICL remains a syndrome of uncertain pathogenesis, prognosis and treatment
Summary
Fernanda Bernadelli De Vito[1], Juliana Lima Ribeiro[2], Ane Rose Lopes Silva[3], Helio Moraes de Souza[4]
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