1988 Volume 29 Issue 11 Pages 2132-2135
We present hereinafter a patient, initially treated for Pneumocystis carinii (P. carinii) pneumonia and terminated adult T-cell leukemia (ATL).
A 56-year-old male was admitted for dry cough and exertional dyspnea in March, 1984. His X-ray examination of chest and transbronchial lung biopsy revealed P. carinii pneumonia. Sulfamethoxazol-trimetoprim showed good response and his all symptoms disappeared. Immunological examinations were as follows: Anti ATLA was positive. PPD reaction was negative. Surface phenotype of blood lymphocytes showed decrease of OKT4 positive cells and inversion of OKT4/OKT8. A few abnormal lymphocytes with nuclear indentation or lobulation were seen in the peripheral blood.
After about 1 year, he was again admitted in our hospital for marked lymphocytosis with nuclear abnormality, hepatomegaly and lymphadenopathy. The diagnosis of ATL was made. Combined chemotherapy with supportive therapy was poorly effective and he died with intestinal bleeding.
This case is very noteworthy from the point of view of immunological function of human T-cell leukemia virus carrier before outbreak of ATL.
