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Immune syndrome remains mysterious.

The strange immune system illness that surfaced last year at the International Conference on AIDS appears to represent a grab bag of different diseases, according to several scientific reports.

Last summer, doctors reported they had discovered a few people who suffered from a puzzling AIDS-like illness but who were not infected with HIV, the virus that causes AIDS (SN: 8/1/92, p.70). Those reports ignited the fear that an unidentified virus might cause the new malady, which was characterized by a depletion of CD4-positive T-lymphocytes, the infection-fighting white cells that are also targets of HIV.

Six scientific reports published in the Feb. 11 NEW ENGLAND JOURNAL OF MEDiCiNE offer the general public some reassuring news about the syndrome.

"It's rare and it's not AIDS," says Scott D. Holmberg of the Centers for Disease Control and Prevention in Atlanta. "We think we're looking at a number of different things that manifest as low lymphocyte counts."

The syndrome now has a name: idiopathic CD4-positive T-lymphocytopenia, or ICL. The term means that a person has fewer than 300 T-lymphocytes per cubic millimeter of blood and that this count cannot be explained by immunosuppressive drugs or other factors. Healthy people have between 500 and 1,600 such cells in the same amount of blood and thus can fight off common microbes that cause infections.

Holmberg and his colleagues conducted an all-out search for examples of this syndrome. After combing through 230,179 cases in the federal AIDS files, they found just two people who were HIV negative but who suffered from low white cell counts. When the researchers asked doctors to report cases that looked like ICL, they found another 45.

To determine whether the disease is contagious, the researchers interviewed many of the people suffering from ICL, as well as people closely associated with them. None of the roommates, spouses, children, or sex partners showed any sign of low white blood cell counts.

In addition to the article by Holmberg, five other reports rounded out the picture of ICL. All argued against the theory that ICL can be pegged to one infectious agent. In addition, the experts stressed that the syndrome appears to follow a variable clinical course: While some people with ICL died, others showed spontaneous improvements in their white cell counts and appeared healthy.

Despite the progress, scientists still don't know what causes ICL, Holmberg adds.
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Title Annotation:idiopathic CD4-positive T-lymphocytopenia
Author:Fackelmann, Kathy A.
Publication:Science News
Date:Feb 20, 1993
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