J-LSMS 2017 | Annual Archive

JOURNAL OF THE LOUISIANA STATE MEDICAL SOCIETY

RADIOLOGY CASE OF THE MONTH

Idiopathic CD4 Lymphocytopenia

Chris Malone, BS, Neel D Gupta, MD, Amit Kothari, MD, Enrique Palacios, MD, Harold Neitzschman, MD

A 39 year-old male with a history of diabetes, retinitis pigmentosa, and genital warts presented with intractable occipital headaches accompanied with nausea and vomiting. The patient had markedly depressed CD4 counts. Furthermore the patient tested negative for HIV and HTLV 1/2 and had normal immunoglobulin levels. During hospital course the patient underwent a lumbar puncture andmultiple imaging exams, including both CT and MR. Except for occasional nausea and vomiting controlled by therapeutic lumbar punctures, phenergan, and dilaudid the patient’s hospital course was uncomplicated.

Figure 1a . Axial FLAIR image

Figure 1b. Axial T2 Weighted Image

Figure 1c. Axial T1WI with contrast

Figure 2a. Sagittal T1WI with contrast

Figure 2b. Axial T1WI with contrast

J La State Med Soc VOL 169 MAY/JUNE 2017 85

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