Transient hypogammaglobulinemia in the adult. Functional assessment of T and B lymphocytes.

The woman described suffered from a pruritic erythematous rash, edema, malaise and fever which appeared during Tegretol therapy. The patient was shown to have a severe hypogammaglobulinemia with absence of circulating B lymphocytes, but normal cell-mediated immunity. There was an absence of in vitro immunoglobulin production by the patient's cells, but this was not due to excessive T-suppressor activity or lack of T-cell help. When drug administration was stopped the edema and rash began to recede promptly, and a few months later her serum immunoglobulin levels, antibody titers and in vitro immunoglobulin production became normal. This transient, probably drug-dependent case of hypogammaglobulinemia, added to three previously reported cases, stresses the need of considering non-conventional immunosuppressive drugs as a potential-etiological agent in acquired hypogammaglobulinemia.