T cell deficiency

T cell deficiency
Human T Cell
Specialty Immunology
Types Primary or Secondary[1]
Diagnostic method Delayed hypersensitivity skin test, T cell count[2][3][4]
Treatment Bone marrow transplant, Immunoglobulin replacement[2][1]

T cell deficiency is a deficiency of T cells, caused by decreased function of individual T cells, it causes an immunodeficiency of cell-mediated immunity.[2] T cells normal function is to help with the human body's immunity, they are one of the two primary types of lymphocytes(the other being B cells).

Symptoms and signs

Presentations differ among causes, but T cell insufficiency generally manifests as unusually severe common viral infections (respiratory syncytial virus, rotavirus), diarrhea, and eczematous or erythrodermatous rashes.[2] Failure to thrive and cachexia are later signs of a T-cell deficiency.[2]

Mechanism

In terms of the normal mechanism of T cell we find that it is a type of white blood cell that has an important role in immunity, and is made from thymocytes [5] One sees in the partial disorder of T cells that happen due to cell signaling defects, are usually caused by hypomorphic gene defects[6] Generally, (micro)deletion of 22Q11.2 is the most often seen.[7]

Pathogens of concern

The main pathogens of concern in T cell deficiencies are intracellular pathogens, including Herpes simplex virus, Mycobacterium and Listeria.[8] Also, intracellular fungal infections are also more common and severe in T cell deficiencies.[8] Other intracellular pathogens of major concern in T cell deficiency are:

Diagnosis

The diagnosis of T cell deficiency can be ascertained in those individuals with this condition via the following:[2][4][3]

  • Delayed hypersensitivity skin test
  • T cell count
  • Detection via culture(infection)

Types

Primary or secondary

Lymphoma
  • Secondary causes are more common than primary ones.[9] Secondary (or acquired) causes are mainly:[9]
Complete or partial deficiency

Treatment

Transfused bone marrow in preparation for transplant

In terms of the management of T cell deficiency for those individuals with this condition the following can be applied:[1][2]

Epidemiology

In the U.S. this defect occurs in about 1 in 70,000, with the majority of cases presenting in early life.[2] Furthermore, SCID has an incidence of approximately 1 in 66,000 in California[10]

See also

References

  1. 1 2 3 "Immunodeficiency (Primary and Secondary). Information". patient.info. Retrieved 2017-05-18.
  2. 1 2 3 4 5 6 7 8 9 10 11 Medscape > T-cell Disorders. Author: Robert A Schwartz, MD, MPH; Chief Editor: Harumi Jyonouchi, MD. Updated: May 16, 2011
  3. 1 2 Fried, Ari J.; Bonilla, Francisco A. (2017-05-19). "Pathogenesis, Diagnosis, and Management of Primary Antibody Deficiencies and Infections". Clinical Microbiology Reviews. 22 (3): 396–414. doi:10.1128/CMR.00001-09. ISSN 0893-8512. PMC 2708392. PMID 19597006.
  4. 1 2 "T-cell count: MedlinePlus Medical Encyclopedia". medlineplus.gov. Retrieved 2017-05-18.
  5. ↑ Alberts B, Johnson A, Lewis J, Raff M, Roberts k, Walter P (2002) Molecular Biology of the Cell. Garland Science: New York, NY pg 1367
  6. ↑ Cole, Theresa S.; Cant, Andrew J. (2010). "Clinical experience in T cell deficient patients". Allergy, Asthma & Clinical Immunology. 6: 9. doi:10.1186/1710-1492-6-9. ISSN 1710-1492. PMC 2877019. PMID 20465788.
  7. ↑ Prasad, Paritosh (2013). Pocket Pediatrics: The Massachusetts General Hospital for Children Handbook of Pediatrics. Lippincott Williams & Wilkins. p. Google books gives no page. ISBN 9781469830094. Retrieved 19 May 2017.
  8. 1 2 Page 435 in: Jones, Jane; Bannister, Barbara A.; Gillespie, Stephen H. (2006). Infection: Microbiology and Management. Wiley-Blackwell. ISBN 1-4051-2665-5.
  9. 1 2 3 4 5 6 7 8 9 10 11 12 Page 432, Chapter 22, Table 22.1 in: Jones, Jane; Bannister, Barbara A.; Gillespie, Stephen H. (2006). Infection: Microbiology and Management. Wiley-Blackwell. ISBN 1-4051-2665-5.
  10. ↑ http://emedicine.medscape.com/article/885493-overview#a5

Further reading

  • Verbsky, James W.; Chatila, Talal A. (2017-05-12). "T Regulatory Cells in Primary Immune Deficiencies". Current Opinion in Allergy and Clinical Immunology. 11 (6): 539–544. doi:10.1097/ACI.0b013e32834cb8fa. ISSN 1528-4050. PMC 3718260. PMID 21986549.
Classification
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