Lymphocytosis ofγ/δT Cells in Human Ehrlichiosis

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Abstract
The majority of T cells in peripheral blood express a T-cell receptor (TCR) comprised of α and β chains. An alternate form of the TCR is comprised of γ and δ chains. These γ/δ T cells are associated with certain infectious lesions, and modestly elevated in peripheral blood in certain disease states. Human ehrlichiosis is characterized by hematologic abnormalities including multi-lineage cytopenias. In most cases reported, a lymphocytopenia has been present either at diagnosis, or at some time during the illness. Early in the course of antibiotic treatment (48–72 hours), the lymphocytopenia corrects itself and is rapidly followed by a lymphocytosis of T cells that express CD3, but are negative for CD4 and CD8, as well as the major form of the TCR formed by the α/β heterodimer. Instead, these CD3+4–8– T cells express the γ/δ heterodimer associated with Vγ9 and Vδ2 chains, a population of cells usually the distinctive minority of peripheral blood T cells, but constituting the major phenotype of peripheral γ/δ T cells.

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