Lymphopenia and Severe Combined Immunodeficiency (SCID) - Think Before You Ink

Indian J Pediatr. 2019 Jul;86(7):584-589. doi: 10.1007/s12098-019-02904-9. Epub 2019 Mar 16.

Abstract

Objectives: Severe combined immunodeficiency (SCID) represents one of the most severe forms of Primary immunodeficiency (PID) disorders, characterized by T cell lymphopenia (TCL) and lack of cellular and humoral immune responses. However, not all patients with low T cell lymphocyte counts may have an abnormal T cell immunity and the observed TCL may be a temporary suppression resulting from transient lymphopenia secondary to severe infections. In such cases, it is necessary to estimate the severity of the observed TCL by assessing thymic capabilities.

Methods: In this study, patients clinically suspected of SCID were evaluated for lymphocyte subsets analysis, naïve T cells and T cell receptor excision circles (TREC).

Results: Patients with transient lymphopenia had detectable TREC levels and normal naïve T cells subsets. Normalization of absolute lymphocyte counts, and T cells was seen in the patients after a short duration.

Conclusions: The authors highlight the importance of detailed immunological investigations in an infant with severe infections and lymphopenia before labeling the infant as SCID.

Keywords: Naïve T cells; SCID; TREC; Transient lymphopenia.

Publication types

  • Case Reports

MeSH terms

  • Female
  • Humans
  • Immunity, Humoral
  • Infant
  • Lymphocyte Count
  • Lymphopenia / complications*
  • Lymphopenia / immunology*
  • Male
  • Severe Combined Immunodeficiency / complications*
  • Severe Combined Immunodeficiency / immunology*

Supplementary concepts

  • T-Lymphocytopenia