Kagami Y, Murate T, Ichikawa A, Hotta T, Saitou H
First Department of Internal Medicine, Nagoya University School of Medicine.
Rinsho Ketsueki. 1990 Dec;31(12):1950-4.
We reported a prednisolone effective case of T 8 lymphocytosis. The patient was 83 years old male, who had suffered from hypoplastic anemia for more than 5 years before he admitted to our hospital. His blood picture was peculiar because adding to granulocytopenia, CD8 (+) large granular lymphocytes were dominant among his lymphocytes. A few days after administration of bolus methylprednisolone, prominent reticulocytosis and rapid improvement of anemia occurred and the latter continued for more than 1 year. We performed in vitro study on the mechanism of his cytopenias. The result of Southern blot analysis showed that his blood lymphocytes had a unique rearranged pattern of T cell receptor beta chain gene. Mononuclear cells had an inhibitory effect on autologous and allogenic CFU-E colony formation of bone marrow cells. These facts suggest that colony proliferating CD8 (+) lymphocytes had an inhibitory effect on erythropoiesis in vivo, and prednisolone blocked this inhibitory pathway in this patient.
我们报告了1例泼尼松龙治疗有效的T 8淋巴细胞增多症病例。患者为83岁男性,入院前已患再生障碍性贫血5年多。其血常规表现特殊,除粒细胞减少外,淋巴细胞中CD8(+)大颗粒淋巴细胞占优势。给予大剂量甲泼尼龙几天后,出现明显的网织红细胞增多和贫血迅速改善,且后者持续超过1年。我们对其血细胞减少的机制进行了体外研究。Southern印迹分析结果显示,其血液淋巴细胞具有独特的T细胞受体β链基因重排模式。单核细胞对骨髓细胞的自体和异体CFU-E集落形成有抑制作用。这些事实表明,集落增殖性CD8(+)淋巴细胞在体内对红细胞生成有抑制作用,而泼尼松龙阻断了该患者的这一抑制途径。