CD4 CYTOPENIA AND OCCASIONAL EXPANSION OF CD4-SYNDROME(CD8+ LYMPHOCYTES IN SJOGRENS)

Objectives. To define whether Sjogren's syndrome (SS) patients have ly mphocytopenia compared to healthy controls, and to assess which lympho cyte subset might be involved. The presence of any concurrent infectio n was recorded. Methods. A cohort of ten consecutive patients with SS was studied and the results were compared with ten sex- and age-matche d controls (C). Results. In SS, a significant cytopenia of CD4(+) (679 +/- 338 vs 1110 + 222 cells/mm(3), p < 0.005) and an even move impres sive decrease in the CD4(+)CD45 RA(+) (242 + 154 vs 491 +/- 190 cells/ mm(3), p < 0. 005) subset was observed. An absolute CD4 lymphocytopeni a (CD4(+) < 300 cells/mm(3)) was seen in two patients. ln one patient an unusual finding was the expansion of a double positive population o f CD4(+)CD8(+) lymphocytes. No striking relationship with any particul ar infection was shown. A retrospective review of the absolute CD4(+) cytopenia in 54 consecutive SS cases revealed a prevalence of 5.5%. Co nclusion. Some SS patients have T lymphocytopenia which mainly affects the CD4(+)CD45 RA(+) subset. Occasional cases with absolute CD4 lymph ocytopenia may also be observed These patients show some evidence of m ild recurrent or chronic, but never severe, opportunistic infections.