Berezné Alice, Bono Wafaa, Guillevin Loïc, Mouthon Luc
Service de médecine interne, Hôpital Cochin, AP-HP, université Paris-Descartes, faculté de médecine, Paris (75).
Presse Med. 2006 May;35(5 Pt 2):895-902. doi: 10.1016/s0755-4982(06)74709-1.
Lymphopenia is defined as a peripheral lymphocyte count lower than 1500/mm3 in adults and 4500/mm3 in children younger than eight months of age. We propose a classification of lymphopenia according to the mechanism involved: lymphocyte production defects, including primary immune deficiencies and immune deficiencies secondary to malnutrition or zinc deprivation; excess catabolism, due to causes including radiotherapy, chemotherapy, immunosuppressive therapy, HIV infection, and systemic lupus erythematosus; abnormal lymphocyte trapping, including mainly splenomegaly, certain viral infections, septic shock, extended burns, systemic granulomatosis, and corticosteroids; other causes of lymphocytopenia, with mechanisms that remain poorly understood: ethnicity (Ethiopians), lymphoma, renal insufficiency, and idiopathic CD4 lymphocytopenia.
成人外周血淋巴细胞计数低于1500/mm³,8个月以下儿童低于4500/mm³。我们根据其涉及的机制对淋巴细胞减少症提出一种分类:淋巴细胞生成缺陷,包括原发性免疫缺陷以及继发于营养不良或锌缺乏的免疫缺陷;分解代谢过多,其病因包括放疗、化疗、免疫抑制治疗、HIV感染和系统性红斑狼疮;淋巴细胞异常滞留,主要包括脾肿大、某些病毒感染、感染性休克、大面积烧伤、系统性肉芽肿病和皮质类固醇;淋巴细胞减少症的其他病因,其机制仍了解甚少:种族(埃塞俄比亚人)、淋巴瘤、肾功能不全和特发性CD4淋巴细胞减少症。