Characterization of autoantibodies, immunophenotype and autoimmune disease in a prospective cohort of patients with idiopathic CD4 lymphocytopenia

Author:

Cudrici, Cornelia D

Boulougoura, Afroditi

Sheikh, Virginia

Freeman, Alexandra

Sortino,Ornella

Katz, James D

Sereti, Irini

Siegel, Richard M
Author Address

Immunoregulation Section, Autoimmunity Branch, National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), Intramural Research Program, National Institutes of Health (NIH), Bethesda, MD 20892, USA., HIV Pathogenesis Section, Laboratory of Immunoregulation, National Institute of Allergy and Infectious Diseases/National Institutes of Health, Bethesda, MD, USA., Laboratory of Clinical and Molecular Immunology, NIAID, USA., Clinical Research Directorate, Frederick, National Laboratory for Cancer Research sponsored by the National Cancer Institute, USA., National Institutes of Arthritis and Musculoskeletal and Skin Diseases, National Institutes of Health Clinical Center, USA., HIV Pathogenesis Section, Laboratory of Immunoregulation, National Institute of Allergy and Infectious Diseases/National Institutes of Health, Bethesda, MD, USA. Electronic address: sereti@niaid.nih.gov., Immunoregulation Section, Autoimmunity Branch, National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), Intramural Research Program, National Institutes of Health (NIH), Bethesda, MD 20892, USA. Electronic address: richardmsiegel@gmail.com.,

Abstract:

Characterize autoantibodies and autoimmune diseases in a prospective cohort of patients with Idiopathic CD4 Lymphocytopenia (ICL) a rare immunodeficiency characterized by an absolute CD4+ T count of < 300 cells/µl in the absence of HIV or HTLV infection. Single-Center prospective study of 67 patients conducted over an 11-year period. Rheumatologic evaluation and measurement of autoantibodies were systematically conducted, and flow cytometry of immune cell subsets was performed in a subset of patients. 54% of referred patients had clinical evidence of autoimmunity, with 34% having at least one autoimmune disease, most commonly autoimmune thyroid disease. 19%, had autoantibodies or incomplete features of autoimmune disease. Patients with autoimmune disease had more elevated serum immunoglobulins, and more effector memory T cells than those without autoimmunity. Evidence of autoimmunity, including autoimmune diseases, is more prevalent in ICL than the general population, and should be considered part of this syndrome. Copyright © 2021. Published by Elsevier Inc.

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