Document 0659
 DOCN  M9650659
 TI    CD4+ T-lymphocytopenia without HIV infection: increased prevalence among
       patients with primary Sjogren's syndrome.
 DT    9605
 AU    Kirtava Z; Blomberg J; Bredberg A; Henriksson G; Jacobsson L; Manthorpe
       R; Sjogren's Syndrome Research Centre, Department of Rheumatology,;
       Malmo University Hospital, Sweden.
 SO    Clin Exp Rheumatol. 1995 Sep-Oct;13(5):609-16. Unique Identifier :
       AIDSLINE MED/96127306
 AB    OBJECTIVE. Primary Sjogren's syndrome (1 degree SS) is an autoimmune
       disease, usually accompanied by manifest immune hyperactivity. In some
       cases the disease converts to malignant neoplasia. On the other hand,
       there are clinical similarities to HIV infection. Since the rare
       phenomenon of persistent depletion of CD4+ T-lymphocytes in peripheral
       blood without HIV infection was recently defined as idiopathic CD4+
       T-lymphocytopenia (ICL), we have used the ICL criteria to investigate
       the prevalence of this phenomenon among 1 degree SS patients. METHODS.
       During the period 1988-94, 115 caucasian patients (10 males), mean age
       57.8 (range 19-82) years, with 1 degree SS were prospectively studied.
       Lymphocyte subsets were investigated by means of monoclonal antibodies
       and flow cytometry. For the detection of HIV and HTLV antibodies, we
       used an enzyme immunoassay (for HIV-1 and HIV-2), Western blot
       techniques (HIV-1, HIV-2, HTLV-I and HTLV-II), and the polymerase chain
       reaction procedure (HIV-1, HTLV-I and HTLV-II). HIV antigens were tested
       for with the HIV-1 p-24 Ag test. RESULTS. Six patients with 1 degree SS
       fulfilled the criteria for ICL. While the clinical condition of 5 of
       those six patients remained stable, one patient developed malignant
       lymphoma three years after her disease was classified as a case of ICL.
       The prevalence of ICL among our 115 patients with 1 degree SS was 5.2%,
       which is significantly higher than the rates reported for any other
       patient or population group. We have estimated the relative risk of ICL
       in 1 degree SS patients to vary from 3.4 to 6,000 (P values of
       0.0001-0.025). CONCLUSION. We suggest that subjects with ICL should be
       carefully examined for 1 degree SS and, if its presence is confirmed,
       that they should be followed with regard to the possible complications
       of this disease, including the development of malignant lymphoma.
 DE    Adult  Aged  Aged, 80 and over  Case Report  CD4 Lymphocyte Count
       Diagnosis, Differential  Female  Human  HIV
       Infections/*DIAGNOSIS/IMMUNOLOGY  HTLV-BLV Antibodies/BLOOD  Male
       Middle Age  Prevalence  Prospective Studies  Retrospective Studies
       Sjogren's Syndrome/*COMPLICATIONS/*IMMUNOLOGY  Support, Non-U.S. Gov't
       T-Lymphocytopenia, Idiopathic CD4-Positive/*COMPLICATIONS/  *IMMUNOLOGY
       JOURNAL ARTICLE

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