Dear all,
We have a 48 y.o man, previously well, who this year has had an episode of florid multidermatomal VZV, followed a few weeks later by lymphadenopathy with EBV detected in lymph nodes, then progressive ataxia with EBV in CSF by PCR. He has no family history of immunodeficiency, and no identifiable malignancy nor lymphoma. There is no history of HSV encephalitis
His labs show polyclonal hypergammaglobulinaemia and a pan B and T lymphopaenia, total lymphocytes 0.5 x 10^9/L (? a result of the viral infection). Repeatedly HIV negative.
He seems to have acquired a problem with herpesviruses - does anyone in Australia do TLR3 sequencing? Or have an interest in investigating that pathway?
Given his generalised lymphadenopathy (not that big - only up to 12mm) with EBV in the nodes, would anyone consider XLP in a man of this age, and without hypogammaglobulinaemia?
Thanks for your thoughts,
Catherine Toong
Immunologist
Liverpool hospital, Sydney.
