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International Journal of Hematology

, Volume 75, Issue 3, pp 285–288 | Cite as

Successful Immunosuppressive Therapy With Cyclosporine A for Posthepatitis B-Cell Deficiency With Activated Cytoplasmic Interferon-γ—Positive T-Lymphocytes

  • Hiroko Otsubo
  • Ken Kaito
  • Yoji Ogasawara
  • Takaki Shimada
  • Noriko Usui
  • Masayuki Kobayashi
Case Report

Abstract

We describe a patient with transient disappearance of B-cells, hypogammaglobulinemia, and mild pancytopenia after acute hepatitis. Both HLA-DR+CD8+ and intracellular interferon-γ+/interleukin-4- cell levels were markedly increased, resulting in an increase in the cytotoxic T-cell (T C )1/T C 2 and helper T-cell (T h )1/T h 2 ratios. After immunosuppressive therapy with cyclosporine A, these parameters of T-cell activation were clearly decreased, and hematologic recovery, including an increase in B-lymphocytes and immunoglobulin concentration, was obtained. These results suggest that there had been suppression of B-cells by activated T-cells. Some patients with common variable immunodeficiency show similar activation of T-cell function, and the present findings suggest the possibility of immunosuppressive therapy for such patients.

Key words

CVID Posthepatitis B-cell deficiency Immunosuppressive therapy Cyclosporine A Activated T-cell 

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References

  1. 1.
    Primary immunodeficiency diseases. Report of a WHO scientific group.Clin Exp Immunol. 1997;109(suppl 1):1–28.Google Scholar
  2. 2.
    Wright JJ, Wagner DK, Blasese M, Hagengruber C, Waldman TA, Fleisher TA. Characterization of common variable immunodeficiency: identification of a subset of patients with distinctive immunophenotypic and clinical features.Blood. 1990;76:2046–2051.Google Scholar
  3. 3.
    North ME, Ivory K, Funauchi M, Webster ADB, Lane AC, Farrant J. Intracellular cytokine production by human CD4+ and CD8+ T cells from normal and immunodeficient donors using directory conjugated anti-cytokine antibodies and three color flow cytometry.Clin Exp Immunol. 1996;105:512–522.CrossRefGoogle Scholar
  4. 4.
    Cunningham-Rundles C, Bodian C. Common variable immunodeficiency: clinical and immunological features of 248 patients.Clin Immunol. 1999;92:34–48.CrossRefPubMedPubMedCentralGoogle Scholar
  5. 5.
    Zoumbos NC, Gascon P, Djeu JY, Trost SR, Young NS. Circulating activated suppressor T lymphocytes in aplastic anemia.N Engl J Med. 1985;312:257–265.CrossRefPubMedGoogle Scholar
  6. 6.
    Brown KE, Tisdale J, Barrett JA, Dunbar CE, Young NS. Hepatitis-associated aplastic anemia.N Engl J Med. 1997;336:1059–1064.CrossRefPubMedGoogle Scholar
  7. 7.
    Oliva A, Scala E, Quinti I, et al. IL-10 production and CD40L expression in patients with common variable immunodeficiency.Scand J Immunol. 1997;46:86–90.CrossRefPubMedGoogle Scholar
  8. 8.
    North ME, Webster ADB, Farrant J. Primary defect in CD8+ lymphocytes in the antibody deficiency disease (common variable immunodeficiency): abnormalities in intracellular production of interferon-gamma (IFN-γ) in CD28+ (“cytotoxic”) and CD28- (“suppressor”) CD8+ subsets.Clin Exp Immunol. 1998;111:70–75.CrossRefPubMedPubMedCentralGoogle Scholar
  9. 9.
    Nordoy I, Muller F, Aukrust P. Froland SS. Adhesion molecules in common variable immunodeficiency (CVID)—a decrease in L-selectin-positive T lymphocytes.Clin Exp Immunol. 1998;114:258–263.CrossRefPubMedPubMedCentralGoogle Scholar
  10. 10.
    Werwitzke S, Drescher B, Schmidt RE. Witte T. CD8+ T cell populations in common variable immunodeficiency.Immunobiology. 2000;202:168–171.CrossRefGoogle Scholar
  11. 11.
    Zuccaro G, Della Bella S, Polizzi M, Scorza R. Common variable immunodeficiency following Epstein-Barr virus infection.J Lab Immunol. 1997;49:41–45.Google Scholar
  12. 12.
    Frickhofen N, Kaltwasser JP, Schrenmeier H, et al. Treatment of aplastic anemia with antithymocyte globulin and methylpred-nisolone with or without cyclosporine.N Engl J Med. 1991;342:1297–1304.CrossRefGoogle Scholar

Copyright information

© The Japanese Society of Hematology 2002

Authors and Affiliations

  • Hiroko Otsubo
    • 1
  • Ken Kaito
    • 1
    • 2
  • Yoji Ogasawara
    • 1
  • Takaki Shimada
    • 1
  • Noriko Usui
    • 1
  • Masayuki Kobayashi
    • 1
  1. 1.Division of Hematology and Oncology, Department of Internal MedicineJikei University, School of MedicineTokyoJapan
  2. 2.Division of Central Clinical LaboratoryJikei University, School of MedicineTokyoJapan

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