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Human T‐lymphotropic virus type I‐associated benign transient immature T‐cell lymphocytosis
Author(s) -
Ehrlich Garth D.,
Han Tin,
Bettigole Richard,
Merl Stuart A.,
Lehr Bruce,
Tomar Russell H.,
Poiesz Bernard J.
Publication year - 1988
Publication title -
american journal of hematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.456
H-Index - 105
eISSN - 1096-8652
pISSN - 0361-8609
DOI - 10.1002/ajh.2830270112
Subject(s) - lymphocytosis , serology , human t lymphotropic virus , immunology , antibody , virus , immunofluorescence , medicine , virology , antigen , biology , myelopathy , psychiatry , spinal cord
We describe a case of human T‐lymphotropic virus type I (HTLV‐I)‐associated transient benign immature T‐cell lymphocytosis in a black female patient, which over the course of several months underwent spontaneous complete remission. The patient presented with a white blood cell count of 20,000/μl and a T4/T8 ratio of 1.7:1. The majority of cells appeared to be lymphoid in origin, and cell marker analyses established that the circulating lymphocytes were predominantly immature T‐cells. HTLV‐I was detected at this time by a p19 indirect immunofluorescent slide assay. Over a 1‐month period of time the patient's clinical status evolved into a mature T‐lymphocytosis with a T4/T8 ratio of 4.5:1. HTLV‐I was detected by anti‐p19 immunofluorescence by cell sorter analyses and by dot‐bloc nucleic acid hybridization. Serological testing demonstrated that the patient had anti‐HTLV‐I antibodies and antimembrane antibodies specific for an HTLV‐I producing cell line. In a competitive HTLV‐I ELISA assay only HTLV‐I proteins could effectively compete out the seroreactivity. The patient also had a high serum level of soluble interleukin‐2 (IL‐2) receptors, which is associated with HTLV‐I infection. This is the first reported case of immature T‐lymphocytosis in a patient infected with HTLV‐I. The patient's HTLV‐I markers disappeared with time, and her lymphocytosis subsequently spontaneously resolved. She remains disease free and virus negative after 2 years of follow‐up study.