A Case of Pneumocystis Pneumonia Secondary to Idiopathic CD4+ T-lymphocytopenia: A Comparison of AIDS and Non-AIDS Patients

Kazuki Sone; Hideki Muramatsu; Makoto Nakao; Yusuke Kagawa; Ryota Kurokawa; Hidefumi Sato; Akio Niimi

doi:10.2169/internalmedicine.8746-16

This article has now been updated. Please use the final version.

A Case of Pneumocystis Pneumonia Secondary to Idiopathic CD4+ T-lymphocytopenia: A Comparison of AIDS and Non-AIDS Patients

Kazuki Sone, Hideki Muramatsu, Makoto Nakao, Yusuke Kagawa, Ryota Kurokawa, Hidefumi Sato, Akio Niimi

Author information

Kazuki Sone
Department of Respiratory Medicine, Kainan Hospital Aichi Prefectural Welfare Federation of Agricultural Cooperatives, Japan
Hideki Muramatsu
Department of Respiratory Medicine, Kainan Hospital Aichi Prefectural Welfare Federation of Agricultural Cooperatives, Japan
Makoto Nakao
Department of Respiratory Medicine, Kainan Hospital Aichi Prefectural Welfare Federation of Agricultural Cooperatives, Japan
Yusuke Kagawa
Department of Respiratory Medicine, Kainan Hospital Aichi Prefectural Welfare Federation of Agricultural Cooperatives, Japan
Ryota Kurokawa
Department of Respiratory Medicine, Kainan Hospital Aichi Prefectural Welfare Federation of Agricultural Cooperatives, Japan
Hidefumi Sato
Department of Respiratory Medicine, Kainan Hospital Aichi Prefectural Welfare Federation of Agricultural Cooperatives, Japan
Akio Niimi
Department of Respiratory Medicine, Allergy and Clinical Immunology, Nagoya City University Graduate School of Medical Sciences, Japan

Keywords: Pneumocystis pneumonia, Human immunodeficiency virus, Idiopathic CD4+ T-lymphocytopenia, low CD4/CD8 ratio

JOURNAL OPEN ACCESS Advance online publication

Article ID: 8746-16

DOI https://doi.org/10.2169/internalmedicine.8746-16

The final version of this article is now available: Vol. 57 (2018), No. 3 pp. 383-386

Details

Abstract

A 67-year-old man was admitted to our hospital complaining of dry cough. Chest computed tomography showed diffuse infiltrates and ground-glass opacities in the bilateral lung fields. Transbronchial lung biopsy specimens showed alveoli filled with yeast-like fungi. With a diagnosis of pneumocystis pneumonia (PCP), he was given oral sulfamethoxazole/trimethoprim, to which he responded well. However, seven months later, PCP relapsed. Analyses revealed a low bronchoalveolar lavage fluid CD4/CD8 ratio of 0.04 and CD4+ lymphocytopenia (250/μL). Despite intensive work-up, we were unable to detect the underlying cause of CD4+ lymphocytopenia; therefore, a final diagnosis of idiopathic CD4+ T-lymphocytopenia was made.

Corresponding author

Register with J-STAGE for free!