A Case of Crohn's Disease with Increased CD8 T-Cell Activation and Remission during Therapy with Intravenous Immunoglobulins

Abstract

Background: Crohn's disease (CD) represents a chronic inflammatory bowel disease with abnormal CD8 T-cell function in a subgroup of patients. Methods: A 55-year-old woman presented with CD on the basis of clinical, endoscopic, radiologic, histologic, and sonographic examination. Since the disease could not be controlled with conventional anti-inflammatory therapy, a detailed analysis of cellular and humoral immune functions was performed and showed a dysbalanced T-cell activation pattern with an inverse CD4/CD8 ratio due to an increased number of CD8 T cells. Additionally, high IgM and low IgG2 antibody levels were detected. Treatment with intravenous immunoglobulin (IVIG) was started as immunomodulatory therapy. During this therapy the condition improved markedly. CD8 T-cell levels returned to normal, and IgM decreased as well. Conclusion: This case shows that selected cases of CD may be associated with abnormal functions and that such patients may benefit from IVIG treatment.