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후천성 면역 결핍증 환자 ( AIDS ) 의 혈액면역학적 특성과 기회감염에 대한 임상적 고찰
남태수(Tae Su Nam),서경수(Keung Su Seo),이경인(Kyong In Lee),김윤성(Yun Seong Kim),홍진희(Jin Hee Hong),김광하(Gwang Ha Kim),정준훈(Joon Hoon Jeong),주형준(Hyung Jun Chu),박승근(Seung Keun Park),성낙현(Nak Hean Seoung),정주섭(Ju Sup 대한내과학회 1997 대한내과학회지 Vol.52 No.1
N/A The number of persons with HIV infection in Korea have increased steadily, total number of HIV infection in Korea were 478 on August, 1995. To investigate the clinicoimmunologic manifestation of AIDS in Korea, we reviewed complete blood counts (CBC), CD4 counts, serum β2-microglobulin level, opportunistic infections and cause of death for 19 AIDS patients who had been admitted or visited at Pusan national university hospital during the period of January, 1990 to August, 1995. 1) The predominant mode of HIV transmission was heterosexual contact(18), other modes of transmission were homosexual contact(1). Clues of diagnosis of HIV infection were routine occupational health examination(14), and opportunistic infection symptoms such as fever, coughing(4). 2) Mean CD4 cell counts(/mm3) were 53±72 totally, 22±27 for 8 dead patients at mean 2 month before, 91±87 for 7 living patients. There were not significant difference(p>0.05). 3) Serum β2-microglobulin(MG;ug/ml) was measured at 12 patients, mean serum β2-MG level was4.8±7.3 totally, 7.1±10.3 for 6 dead patients at mean 1.3 month before, 2.5±0.4 for 6 living patients. There were not significant(p>0.05). 4) At CBC examination, WBC(/mm3) was 5,932±2,899 totally, 5,452±3,436 for 10 dead patients, 6,500 ±2,221 for 9 living patients(p>0.05). Hb(g/dl) was 11,4±2.8 totally, 9.4±1.8 for dead patients, 13.6±1.8 for living patients(p<0.05). Lymphocyte count(/mm) was 1,255±800 totally, 731±424 for dead patients, 1,838716 for living patients(p<0.05). ESR(mm/h) was 72±47 totally, 97±33 for dead patients, 47±47 for living patients(p<0.05). 5) Opportunistic infections had developed at 14 patients, candidiasis 7, pneumocystis carinii pneumonia 5, tuberculosis 3, cytomegalovirus infection 2, herpes zoster 3, toxoplasmosis 1, cryptococcal infection 2, bacterial pneumonia 5, and herpes simplex l. Malignant lymphoma had developed in 1 patient. 6) Mean survival interval from diagnosis of HIV infection to death was 32.8±19.1 months, and the most common cause of death was pneumocystis carinii pneumonia, and other causes of death were meningitis, bacterial pneumonia and AIDS-wasting syndrome. Based on these results, We concluded that CD4 counts, serum β2-microglobulin level, Hb, total lymphocyte count and ESR in AIDS patients are specific laboratory markers of progression and prognosis of AIDS, the most common opportunistic infection was candidiasis, and the most common cause of death in AIDS patients was pneumocystis carinii pneumonia.
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카포시 육종, 주폐포자층 폐렴 등을 동반한 특발성 CD4+ T 림프구감소증 1 예
김준홍,김병진,정영태,고원욱,김사웅,조군제,정주섭,남태수,서경수,성낙현,김부웅 대한내과학회 1996 대한내과학회지 Vol.51 No.4
The recently recognized immunodeficiency syndrome of idiopathic CD4+ T-lymphocytopenia was defined by the Centers for Disease Control and Prevention (CDC) to include depressed numbers of circulating CD4+ T-lymphocytes ($lt;300 cells/㎣ or $lt;20% of total T cells) on more than one occasion, no laboratory evidence of infection with human immunodeficiency virus type 1(HIV-1) or type 2 (HIV-2), and the absence of any defined immunodeficiency or therapy associated with depressed levels of CD4+ T cells. We had experienced one case of Idiopathic CD4+ T-lymphocytopenia without HIV infection, combined with Kaposi's sarcoma and Pneumocystis carinii pneumonia. She had visited to emergency room due to moderate dyspnea and fever for about three months. On physical examination, multiple purple colored mass lesions were detected on lower back, both upper and lower extremities and right tonsillar area. Skin biopsy on mass of right lower extremity revealed Kaposi's sarcoma. On HRCT of the chest, patch bilateral, symmetric reticulonodular infiltration were founded. So, we performed sputum cytology repeatedly, we identified pneumocystis carinii cysts. Idiopathic CD4+ T-lymphocytopenia is rare and represents various clinical and immunologic states. It is perhaps more important to work harder to track the epidemiologic feature of this syndrome closely, to define the associated immune deficits carefully, and to search broadly for the cause. Further epidemiologic, immunologic, and virologic studies will aid in the characterization of this newly recognized condition.
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