Restoration of Defective Cellular Immunity by Levamisole in a Patient with Immunoblastic Lymphadenopathy

Abstract

A 71 yr old woman presented with acutely developed symptoms of generalized lymphadenopathy, intermittent maculo-papular skin rash, pruritus, weight loss, hepato-splenomegaly, pleural exudate and alternating breast swellings. The histopathological picture of biopsies from a lymph node and from the skin was diagnostic for immunoblastic lymphadenopathy, and the serum concentrations of IgG [immunoglobulin G] and IgA were increased. Delayed cutaneous hypersensitivity reactions to various antigens were totally extinguished, and the number of T[thymus-derived]-lymphocytes in the peripheral blood was consistently very low. The number of T- and B[bone marrow-derived]-lymphocytes further decreased during cytostatic treatment, and the patient contracted numerous infections. During intermittent treatment with Levamisole, the infectious episodes ceased, the cellular immune response was re-established and the pathological hyperimmunoglobulinemia suppressed. The primary immunological defect in this disease could be a failing cellular immunity, and the hyperplasia and hyper-reactivity of the B-cell system may be a secondary phenomenon.