T cell deficiency

T cell deficiency is a deficiency of T cells, caused by decreased function of individual T cells, it causes an immunodeficiency of cell-mediated immunity.[1] T cells normal function is to help with the human body's immunity, they are one of the two primary types of lymphocytes(the other being B cells).

T cell deficiency
Human T Cell
SpecialtyImmunology
SymptomsEczematous[1]
TypesPrimary or Secondary[2]
Diagnostic methodDelayed hypersensitivity skin test, T cell count[1][3][4]
TreatmentBone marrow transplant, Immunoglobulin replacement[1][2]

Symptoms and signs

Presentations differ among causes, but T cell insufficiency generally manifests as unusually severe common viral infections (respiratory syncytial virus, rotavirus), diarrhea, and eczematous or erythrodermatous rashes.[1] Failure to thrive and cachexia are later signs of a T-cell deficiency.[1]

Mechanism

In terms of the normal mechanism of T cell we find that it is a type of white blood cell that has an important role in immunity, and is made from thymocytes [5] One sees in the partial disorder of T cells that happen due to cell signaling defects, are usually caused by hypomorphic gene defects[6] Generally, (micro)deletion of 22Q11.2 is the most often seen.[7]

Pathogens of concern
Further information: Intracellular pathogen

The main pathogens of concern in T cell deficiencies are intracellular pathogens, including Herpes simplex virus, Mycobacterium and Listeria.[8] Also, intracellular fungal infections are also more common and severe in T cell deficiencies.[8] Other intracellular pathogens of major concern in T cell deficiency are:

Diagnosis

The diagnosis of T cell deficiency can be ascertained in those individuals with this condition via the following:[1][4][3]

  • Delayed hypersensitivity skin test
  • T cell count
  • Detection via culture(infection)

Types

Primary or secondary

Lymphoma
  • Secondary causes are more common than primary ones.[9] Secondary (or acquired) causes are mainly:[9]
Complete or partial deficiency

Treatment
Harvested bone marrow in preparation for transplant

In terms of the management of T cell deficiency for those individuals with this condition the following can be applied:[2][1]

Epidemiology

In the U.S. this defect occurs in about 1 in 70,000, with the majority of cases presenting in early life.[1] Furthermore, SCID has an incidence of approximately 1 in 66,000 in California[10]

See also

References
  1. Medscape > T-cell Disorders. Author: Robert A Schwartz, MD, MPH; Chief Editor: Harumi Jyonouchi, MD. Updated: May 16, 2011
  2. "Immunodeficiency (Primary and Secondary). Information". patient.info. Retrieved 2017-05-18.
  3. Fried, Ari J.; Bonilla, Francisco A. (2017-05-19). "Pathogenesis, Diagnosis, and Management of Primary Antibody Deficiencies and Infections". Clinical Microbiology Reviews. 22 (3): 396–414. doi:10.1128/CMR.00001-09. ISSN 0893-8512. PMC 2708392. PMID 19597006.
  4. "T-cell count: MedlinePlus Medical Encyclopedia". medlineplus.gov. Retrieved 2017-05-18.
  5. Alberts B, Johnson A, Lewis J, Raff M, Roberts k, Walter P (2002) Molecular Biology of the Cell. Garland Science: New York, NY pg 1367
  6. Cole, Theresa S.; Cant, Andrew J. (2010). "Clinical experience in T cell deficient patients". Allergy, Asthma & Clinical Immunology. 6 (1): 9. doi:10.1186/1710-1492-6-9. ISSN 1710-1492. PMC 2877019. PMID 20465788.
  7. Prasad, Paritosh (2013). Pocket Pediatrics: The Massachusetts General Hospital for Children Handbook of Pediatrics. Lippincott Williams & Wilkins. p. Google books gives no page. ISBN 9781469830094. Retrieved 19 May 2017.
  8. Page 435 in: Jones, Jane; Bannister, Barbara A.; Gillespie, Stephen H. (2006). Infection: Microbiology and Management. Wiley-Blackwell. ISBN 978-1-4051-2665-6.
  9. Page 432, Chapter 22, Table 22.1 in: Jones, Jane; Bannister, Barbara A.; Gillespie, Stephen H. (2006). Infection: Microbiology and Management. Wiley-Blackwell. ISBN 978-1-4051-2665-6.
  10. "B-Cell and T-Cell Combined Disorders: Background, Pathophysiology, Epidemiology". 2018-12-11. Cite journal requires |journal= (help)

Further reading
Classification
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