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I have read your immunophenotyping results - I find them diffcult to interpret.
However, I will give you my best shot:
We have to do some guessing, as you have not indicated what populations are
double or perhaps triple positive. ( If you have used single color
protocols, I suggest right away, that you perform double staining, and
discard your present results.)
T-cells : Absolute CD4+ cell numbers are normal, however the CD4:CD8 ratio
is far below normal ( from 1.0 and up), indicating relative CD4+
lymphocytopenia. CD4+% + CD8% = 68%, which is somewhat below the CD3%,
what happened to the rest ? Certainly the percentage of TCR1+ cells
(T-cells not expressing CD4 or CD8) is not 14 %.
B-cells: Absolute and relative B-cell counts are normal (CD19 and CD20),
however the 83% CD23+ cells, I can not explain (why did you include this
marker anyway?).
NK-cells: Absolute and relative numbers are normal, if the reported 14%
CD56+ are CD3-.
Overall: There is a problem, because: CD56% + CD20% +CD3+% = 106%, so you
have an overshoot of 6% or more (your FSC/SSC lymphocyte gate is probaly
not exceeding 95%).
Judged by the relatively low CD4+ count I suspect a viral infection. So,
check your patient for viral markers (Epstein Barr, CMV especially), also
consider HIV-infection. You do have some unexplained results, so I will
also suggest, that you repeat your immunophenotyping using at least double
staining (e.g. the markers CD3/CD19, CD3/CD4, CD3/CD8, CD3/CD16+56,
CD3/HLA-DR and perhaps CD3/CD25 and not CD23). What are the patients
clinical data ?
If you will forward your results in more detail, I will be happy to try
once more.
Best wishes
Ulrik Sprogoe-Jakobsen, MD
Dept. Clinical Immunology
Odense University Hospital
Denmark
FAX +45 6612 7975
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