Successful immunosuppressive therapy with cyclosporine A for posthepatitis B-cell deficiency with activated cytoplasmic interferon-γ-positive T-lymphocytes

We describe a patient with transient disappearance of B-cells, hypogammaglobulinemia, and mild pancytopenia after acute hepatitis. Both HLA-DR(+)CD8(+) and intracellular interferon-gamma(+)/interleukin-4(-) cell levels were markedly increased, resulting in an increase in the cytotoxic T-cell (T-C)1/T(C)2 and helper T-cell (T-H)1/T(H)2 ratios. After immunosuppressive therapy with cyclosporine A, these parameters of T-cell activation were clearly decreased, and hematologic recovery, including an increase in B-lymphocytes and immunoglobulin concentration, was obtained. These results suggest that there had been suppression of B-cells by activated T-cells. Some patients with common variable immunodeficiency show similar activation of T-cell function, and the present findings suggest the possibility of immunosuppressive therapy for such patients. (C) 2002 The Japanese Society of Hematology.