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