BMJ  2003;327:620 (13 September), doi:10.1136/bmj.327.7415.620-b

Letter

SARS: understanding the coronavirus

Apoptosis may explain lymphopenia of SARS

The first 150 words of the full text of this article appear below.

EDITOR—In their review of the severe acute respiratory syndrome (SARS) Wong et al emphasise lymphopenia as a hallmark feature.¹ Panesar suggested that glucocorticoids or stimulation of the hypothalamic-pituitary-adrenal axis leads to lymphocyte margination and that patients without lymphopenia may have adrenal insufficiency.²

Apoptosis may also explain the lymphopenia of SARS. In severe paramyxovirus infections in humans such as measles, lymphopenia is commonly present and associated with more severe disease. One of us with Carrington recently reported that lymphopenia is also seen with another paramyxovirus infection: respiratory syncytial virus, which causes bronchiolitis in young children.³

Children with more severe bronchiolitis from respiratory syncytial virus infection have significantly lower absolute lymphocyte counts than those with mild disease. Bronchiolitis is ubiquitous and, in the developed world, the commonest reason a child under 1 year of age is admitted to hospital. Studies in mice show that not only is the lymphocyte immune . . . [Full text of this article]

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roddy.odonnell@addenbrookes.nhs.uk

Clinical School, University of Cambridge, Cambridge CB2 2QQ

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Haematological manifestations in patients with severe acute respiratory syndrome: retrospective analysis

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Rapid Responses:

Read all Rapid Responses

Lymphopenia mechanism in SARS

Diane D. Addie
bmj.com, 24 Sep 2003 [Full text]

Lymphopenia in SARS: Apoptosis definitely is involved, but is it glucocorticoid or virus induced?

Nirmal S Panesar
bmj.com, 26 Sep 2003 [Full text]

SARS Lymphopenia is No Longer a Riddle

Trevor G Marshall
bmj.com, 28 Sep 2003 [Full text]

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