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Query: UMLS:C0024312 (lymphopenia)
 4,859 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Legionella infections can take the clinical course of a relatively harmless respiratory infection. However, serious, atypical pneumonia is a more frequent manifestation of infection with these pathogens. As yet, six different Legionella species can be identified; Legionella pneumophila appears to be the most common. Legionnaires' pneumonia is being found with increasing regularity during summer and autumn in elderly male patients with previous illnesses. The clinical picture is characterised by viral "prodrome", high fever, a dry cough, breast pain, confusion, diarrhoea, haematuria, moderate leukocytosis with lymphopenia, low concentrations of sodium in the serum and negative results from microbiological analysis of the sputum and pleural exudate. Diagnosis is confirmed culturally, microscopically and serologically; the indirect immunofluorescence test is of particular value for this purpose. Erythromycin alone or in combination with rifampicin is the treatment of choice.
Infection 1982
PMID:[Clinical picture of Legionnaires' disease (author's transl)]. 710 21

Infection of naive North American horses with 10(4) cell culture infectious doses (CCID50) of virulence variants of African horsesickness virus (AHSV), designated AHSV/4SP, AHSV/9PI, and AHSV/4PI, reproduced three classical forms of African horsesickness: acute (pulmonary), subacute (cardiac), and febrile, respectively. Distinct clinicopathologic and hemostatic abnormalities were associated with each form of disease. Hemostatic abnormalities included increased concentration of fibrin degradation products and prolongation of prothrombin, activated partial thromboplastin, and thrombin clotting times. Hemostatic findings indicated activation of the coagulation and fibrinolytic systems with clotting factor consumption in acute and subacute cases of African horsesickness. Hematologic abnormalities in acute and subacute cases of African horsesickness included leukopenia, decreased platelet counts, elevated hematocrit, and increased erythrocyte counts and hemoglobin concentration. Leukopenia was characterized by lymphopenia, neutropenia, and a left shift. Increased levels of serum creatine kinase, lactate dehydrogenase, aspartate aminotransferase, and alkaline phosphatase, hypocalcemia, hypoalbuminemia, hypoproteinemia, and elevated creatinine, phosphorus, and total bilirubin levels were present in some but not all horses. Metabolic acidosis, indicated by decreased total bicarbonate and increased lactate and anion gap, was present in horses with the acute form of disease. Mild thrombocytopenia and leukopenia were occasionally associated with the febrile form of disease. These results suggest a role for intravascular coagulation in the pathogenesis of African horsesickness.
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PMID:Clinical pathology and hemostatic abnormalities in experimental African horsesickness. 777 Oct 50

The risk factors and clinical and laboratory parameters in Pneumocystis carinii pneumonia in patients with Wegener's granulomatosis have not been well characterized. We undertook a retrospective chart review of all patients with a diagnosis of Wegener's granulomatosis and P. carinii pneumonia who were followed at the National Institute of Allergy and Infectious Diseases of the National Institutes of Health. The chart review focused on clinical, laboratory, and roentgenologic evidence of P. carinii pneumonia. Eleven cases of P. carinii pneumonia were diagnosed in some 180 patients with Wegener's granulomatosis, for an overall incidence of approximately 6%. All patients developed P. carinii pneumonia either during the initial course of treatment or during therapy for recurrent Wegener's granulomatosis. All patients were receiving daily glucocorticoids and a second immunosuppressive therapy. Lymphocytopenia was noted in all patients, with a mean +/- SEM total lymphocyte count of 303 +/- 69 cells/microL. All patients tested (10 of 11) were seronegative for human immunodeficiency virus (HIV) infection. Eight presented with worsening chest roentgenograms compared with baseline, whereas three presented with normal chest roentgenograms. We conclude that P. carinii is a common opportunistic pathogen in patients with Wegener's granulomatosis receiving immunosuppressive therapy. Therapeutic immunosuppression (daily glucocorticoids and immunosuppressive agents) and the resultant lymphocytopenia, as well as the lymphocyte and monocyte functional abnormalities caused by glucocorticoids, may be the most likely factors predisposing to P. carinii pneumonia in patients with Wegener's granulomatosis. Based on our data, all patients with Wegener's granulomatosis should be given chemoprophylaxis against P. carinii while they are receiving daily glucocorticoids.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Pneumocystis carinii pneumonia: a major complication of immunosuppressive therapy in patients with Wegener's granulomatosis. 852 Jul 98

Human rhinoviruses (HRV) cause the majority of common colds and are etiologically linked with changes in lower airways physiology and asthma exacerbations. We hypothesized that changes in bronchial mucosal inflammatory cell populations may be responsible for HRV-induced changes in airway reactivity. We examined bronchial mucosal biopsies during experimental infections with HRV serotype 16 and measured changes in histamine reactivity. Seventeen adult volunteers (six atopic asthmatics) had baseline measurements of histamine reactivity and fiberoptic bronchoscopic biopsies, followed 2 wk later by viral inoculation. Further bronchial biopsies were taken on Day 4 of the infection and 6 to 10 wk later. Mast cells, eosinophils, lymphocytes, and neutrophils were quantified by immunohistochemical techniques. Infection was documented by viral culture, seroconversion, and symptoms. An increase in histamine responsiveness during the cold (p = 0.048) was accompanied by increases in submucosal lymphocytes (p = 0.050). There was a subsequent decrease in submucosal and epithelial lymphocytes in convalescence (p = 0.028; p = 0.030). There was an increase in epithelial eosinophils with the cold (p = 0.042), and in asthmatics this appeared to persist into convalescence. A peripheral blood lymphopenia correlated with increased responsiveness (r = 0.062, p = 0.014). Rhinoviral colds are associated with a bronchial mucosal lymphocytic and eosinophilic infiltrate that may be related to changes in airway responsiveness and asthma exacerbations.
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PMID:Lower airways inflammation during rhinovirus colds in normal and in asthmatic subjects. 788 86

Examinations were made on erythrocytes, thrombocytes, leukocytes, lymph nodes, thymus, haemal nodes and bone marrow in field cases of East Coast Fever (ECF) in Tanzania. Seventy-six clinically sick short-horn Zebu and Taurine-Zebu crosses, positive for Theileria parva piroplasms and schizonts and 55 apparently healthy cattle were studied. The syndrome observed was characterised by severe pancytopenia, with massive normocytic, normochromic anaemia, panleukopenia and thrombocytopenia, but no reticulocytes in peripheral blood. The erythrocyte and leukocyte counts, haematocrit and haemoglobin concentrations were greatly decreased compared with those of the healthy cattle. The means +/- SD (with values of healthy cattle in parentheses) were 2.85 +/- 1.10 (6.04 +/- 1.58) x 10(12) l-1, 2.78 +/- 1.70 (10.59 +/- 4.16) x 10(9) l-1, 0.19 +/- 0.06 (0.31 +/- 0.054)1 l-1 and 4.07 +/- 1.62 (7.29 +/- 1.39) mmol l-1 respectively. Lymphoproliferation was low, while lymphocyte destruction (lymphocytolysis) was high. There were very few small schizonts in parotid and prescapular glands. Lymphocytes were extensively destroyed in medullary cords, germinal centres of lymph nodules in cortex and paracortical regions of lymph nodes and haemal nodes. The bone marrow was hypocellular, with only a few haematopoietic precursor erythroid, granulocytic and thrombopoietic cell series. All stages of prorubriblasts and rubricytes had granulated nuclei, some with schizonts. Infection of erythrocytes by merozoites appeared to take place in precursor stages. The destruction of erythroblasts, rubricytes and other haematopoietic cells resulted in anaemia without reticulocytosis, haemoglobinuria and jaundice, accompanied by panleukopenia of extreme neutropenia, lymphopenia and eosinopenia. This indicated that this T. parva strain differs from previously described buffalo- or cattle-derived T. parva infections in causing both haemoproliferation and lymphoproliferation by extensive haematopoietic cell destruction and lymphocytolysis. In cattle- and buffalo-derived T. parva infections, anaemia is normally mild and there are numerous large schizonts in the former.
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PMID:Severe anaemia due to haematopoietic precursor cell destruction in field cases of East Coast Fever in Tanzania. 807 8

Very few data on the frequency and diversity of haematological abnormalities occurring in brucellosis in children have been reported. In the present study 110 children (56 boys and 54 girls; age range, 2 months to 14 years) with proven brucellosis were investigated to determine the haematological changes during the active course of this infection. Anaemia was detected in 48 (44%) patients, of whom four had evidence of haemolysis. Leukopenia occurred in 33% of the cases, with neutropenia and/or lymphopenia being the most striking features encountered. Thrombocytopenia was found in six (5%) patients and pancytopenia in 15 (14%) patients, of whom one developed disseminated intravascular coagulation. Clinically detectable bleeding occurred in five (4.5%) patients whose platelet counts were significantly low. Hypersplenism, haemophagocytosis and granulomatous lesions of the bone marrow appear to play a fundamental role in producing these abnormalities of the peripheral blood. Brucellosis may be considered in patients whose blood picture reveals haemolytic anaemia, leukopenia, thrombocytopenia or pancytopenia, particularly when the disease is epidemiologically suspected.
Infection
PMID:Haematological manifestations of childhood brucellosis. 844 76

Infection with the human immunodeficiency virus (HIV) has changed both the epidemiology and natural history of tuberculosis. Despite a generally good response to effective antituberculous therapy, the prognosis remains poor. The objective of this analysis was to determine the independent predictors of survival in HIV-infected Ugandan adults with smear-positive pulmonary tuberculosis. A total of 191 HIV-infected Ugandan adults with smear-positive pulmonary tuberculosis were enrolled into a clinical trial of chemotherapy for tuberculosis. The subjects received either rifampin, isoniazid, and pyrazinamide for two months, followed by rifampin and isoniazid for six months (n = 101) or streptomycin, thiacetazone, and isoniazid for two months followed by thiacetazone and isoniazid for eight months (n = 90). After standard measurements were made at baseline, the group was followed at regular intervals for a mean of 16 months to determine survival. During the course of follow-up, 82 (43%) of the patients died, six within the first month of therapy. The one-year survival proportion was 68% with an estimated median survival of 26 months and did not differ according to treatment regimen. The hazard for death was biphasic, high early in the course of therapy, and then again after about one year. After controlling for the treatment regimen, four independent predictors of survival were found: anergy to purified protein derivative, atypical chest roentgenogram, previous HIV-related condition, and lymphopenia. In this cohort of Ugandan adults, four simple and inexpensive predictors of survival were found. These factors suggest that the degree of immunosuppression was a major determinant of survival.
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PMID:Predictors of survival in human immunodeficiency virus-infected patients with pulmonary tuberculosis. The Makerere University-Case Western Reserve University Research Collaboration. 866 64

Valvular endocarditis is the most serious complication of chronic Q fever, an infectious disease due to Coxiella burnetii. Although its pathogenesis is poorly understood, the role of the immune system has been evoked. The aim of this study was to investigate lymphocyte subsets in the peripheral blood of infected patients by analyzing the distribution of T- and B-lymphocyte subsets. Since various infectious diseases have been found to be associated with modified antigen expression, we also measured the antigen density of the main lymphocyte markers by quantitative flow cytometry. The absolute values of CD3+ T cells and CD19+ B cells were lower in infected subjects than in controls. The decrease in the CD4+ T-cell count was more pronounced than that in the CD8+ T-cell count, leading to a significantly lower CD4/CD8 ratio in patients. The decreases in CD4+ T cells and CD19+ B cells were correlated with levels of C. burnetii-specific immunoglobulin G, showing that CD4+ lymphopenia is related to the activity of chronic Q fever. Quantitation of antigen expression on lymphocytes showed that CD3, CD4, CD8, and CD19 were expressed similarly in patients and controls. In contrast, CD2 and CD11a expression levels, which are both related to naive and memory phenotypes, were modified in patients. The study of CD45RO and CD45RA expression by CD4+ T cells provided evidence that lymphopenia preferentially affected unprimed lymphocytes.
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PMID:CD4+ T-cell lymphopenia in Q fever endocarditis. 900 88

Mixed connective tissue disease (MCTD) was described as a distinct clinical syndrome in 1972. Since then many cases have been reported in the literature worldwide. In this study we present our experience with a group of 17 Mexican patients with this syndrome, and we analyze their clinical and serological features, as well as the causes of death in these patients. The patients are Mexican mestizos living in Guadalajara and most of them have been followed-up at Hospital General de Occidente for a period of 1-10 years. The female/male ratio was 16:1, and their age ranged from 14-55 years with a mean of 29 years. The disease duration has ranged from 1-17 years, with a mean of 6 years. Among the clinical manifestations we have found a high frequency of lymphadenopathy when compared with published series (13/17 or 76%), and the laboratory findings in our patients included a very high polyclonal increase of gammaglobulins (93%), lymphopenia (76%), direct immunofluorescence speckled nuclear epidermal deposits in skin biopsies (75%) and positive rheumatoid factor (65%). Other clinical and serological features were similar to those reported in other series of patients with MCTD. Six of the 17 patients have died (35%), and in 3 of them (17.5%) the cause of death was due to an infectious disease that suddenly presented, and apparently was not related to a concomitant high dose of steroids or malnutrition in the patients. It seems that in addition to the already well known autoimmune abnormalities that occur in MCTD, there are other features like the presence of lymphadenopathy, the high polyclonal increase of gammaglobulins, and the lymphopenia, that reflect the profound disturbance of the immune system in this syndrome, possibly contributing to the sudden appearance of a severe infectious disease in some of our patients.
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PMID:Mixed connective tissue disease. A clinico-serological study of 17 cases. 911 23

Infection of pigs with classical swine fever virus (CSFV), a member of the Flaviviridae family, causes a severe leukopenia, particularly notable with the lymphocytes. The goal of this study was to analyze mechanisms behind this CSFV-induced lymphopenia. To this end, the kinetics of leukocyte depletion, the appearance of apoptotic cells, and virus infection of leukocytes after infection of pigs with the virulent CSFV strain Brescia were analyzed. Depletion of B and T lymphocytes was noted as early as 1 day postinfection (p.i.). Circulating viable lymphocytes with reduced mitochondrial transmembrane potential--a particular early marker for apoptosis--were also detectable as early as 1 day p.i. When isolated peripheral blood mononuclear cells were cultured for 6 h, significantly more sub-G1 cells with reduced DNA content were detected among the lymphocytes from CSFV-infected animals, again as early as 1 to 3 days p.i. The first time virus was first found in the plasma, as well as infection of leukocytes, was 3 days p.i. However, throughout the observation time of 1 week, <3% of the circulating leukocytes and no lymphocytes contained virus or viral antigen. Further analysis of the T lymphocytes from infected animals demonstrated an increase in CD49d, major histocompatibility complex class II, and Fas expression. An increased susceptibility to apoptosis in vitro was also observed, particularly after addition of concanavalin A as well as apoptosis-inducing anti-Fas antibody to the cultures. Taken together, these results imply that activation-induced programmed cell death was the mechanism behind lymphopenia during classical swine fever.
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PMID:Lymphocyte apoptosis during classical swine fever: implication of activation-induced cell death. 949 36


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