特发性CD4^+T淋巴细胞减少症1例分析及文献复习

One case report of idiopathic CD4^+ T-lymphocytopenia and literature review

目的分析特发性CD4+T淋巴细胞减少症的临床特点,并探讨其发病机制和治疗。方法对1例以反复发热13d,腹泻7d,嗜睡1d为主诉入院的14个月患儿进行临床和实验室总结,并结合文献进行分析。结果鉴于患儿2次检测外周血T淋巴细胞亚群均提示CD4+T淋巴细胞明显减少,并且排除了HIV感染,也无明显的已知病因或治疗相关因素引起免疫功能抑制,因此最后诊断考虑为:特发性CD4+T淋巴细胞减少症、脑实质炎症、肺炎、腹泻病、鹅口疮、电解质紊乱。结论尽管特发性CD4+T淋巴细胞减少症是一种非常罕见的疾病,但是在临床工作中仍可见到,因此应提高警惕,对出现机会感染和复杂感染的患儿,应及时考虑到免疫功能可能存在问题,尽快明确病因,以利于患儿的治疗和康复。

Objectives To explore the clinical features and treatment of idiopathic CD4^＋ T-lymphocytopenia. Methods The clinical features and laboratory data of a 14-month-old girl with fever, diarrhea and lethargy admitted in November 2004 was analyzed. The similar cases and related literatures were reviewed. Results CD4^＋T-lymphocyte from peripheral blood was obviously decreased. Neither evidence of HIV infection and nor any other causes that can induce immuno-suppression of this patient could be found. The final diagnosis was determined as idiopathic CD4^＋T-lymphocytopenia. Encephalitis, pneumonia, diarrhea, oral candidiasis and electrolyte disturbances were developed during the disease period. Conclusions Though idiopathic CD4^＋T-lymphocytopenia is a rare disease, more attention should be paid to those patients with opportunistic infection or complex infection, and consider the possibility of immunodeficiency.