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Sunday, February 16, 2014

-Lymphocytes_• Lymphocytosis_Combined T and B lymphocyte immunodeficiencies

           
Lymphocytes
          Circulating lymphocytes are small cells, there are two main types T and B lymphocytes.
          Lymphocytosis occurs when lymphocytic count >5x109 in viral infections,EBV, HIV, chronic infections as tuberculosis and Toxoplasmosis, chronic lymphatic leukemia and lymphoma.
          T- cell immunodeficiencies
1-Congenital:
          A defect in thymic development associated with hypoparathyrodisim and cardiac defects. Patients presented with infections including mucocautaneous candidiasis and diarrhea.
           Treatment: thymic transplant, thymic hormone.
          Acquired:
1- Acquired immunodeficiency syndrome
          The priming cellular receptor for HIV is the CD4 molecule.
          The following cells in the immune system are affected:
          A-CD4+ cells T lymphocytes
          B-Monocytes
          C-Macrophage 
          2- Measles
          3-Immunosuppressed drugs
          4-Corticosteriods.
Combined T and B lymphocyte immunodeficiencies
          1- Congenital:
          A –Severe combined immunodeficiency:
          Occurs in the first weeks of life, failure to thrive, absent lymphoid tissue, lymphopenia and hypogammaglobinemia.
          Treatment :
          BMT
          Gene therapy.
          B-Wiskott-Aldrich syndrome
Presented by eczema, thrombocytopenia.
          Acquired lymphopenia:
          1- Protein calorie malnutrition:
          Very common cause of acquired combined immunodeficiency.
          Measles is a major cause of death.
          2-Immune deficiency of prematurity
Premature infants of 26 weeks gestation and under are now surviving and have several immunological deficiencies and problems.
           Antibody continue to drop further after birth.
          Neutropenia and impaired chemotaxis.
          Disruption of host defense barriers e.g insertion of foreign bodies e.g catheters and  antibiotic therapy which reduces resistance produce severe infections.


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