21 July 2026
: Case report 
Tuberculosis in the Context of Idiopathic CD4 Lymphocytopenia: A Case Report and Literature Review
Challenging differential diagnosis, Unusual or unexpected effect of treatment, Rare disease
Sara M. Alwarthan
EFG 1,2*, Abir Hamad Alsaid E 2,3, Ashraf Ezzat Abdelsamad Attia F 2,4,5, Ahmed Alsahlawi E 1,2, Shahad Ali AlZahrani EF 2,6, Khalid Ghazai Alotaibi E 2,6, Hassan Naasr Al Dhneem E 2,6, Marwan Jabr Alwazzeh EF 2,6
DOI: 10.12659/AJCR.953101
Am J Case Rep 2026; 27:e953101
Table 1 Trends in CD4+ cells, CD8+ cells, and the CD4: CD8 ratio during (June 16 and 25, 2025) and following the completion of tuberculosis therapy (October 2, 2025, December 4, 2025, and April 6, 2026).
| Test | Reference range | June 16, 2025 | June 25, 2025 | October 2, 2025 | December 4, 2025 | April 6, 2026 |
|---|---|---|---|---|---|---|
| WBC (cells/μL) | 4000–11 000 | 1600 | 2100 | 2500 | 2900 | 2800 |
| Lymphocytes absolute (cells/μL) | 690–2540 | 228.0 | 252.2 | 381.1 | 349.2 | 384.3 |
| CD4+ T Cells% | 31–60 | 35.5 | 27.9 | 22.8 | 23.6 | 21.1 |
| CD4+ T Cells absolute (cells/μL) | 410–1590 | 103.8 | 105.2 | 134.2 | 147.0 | 153.7 |
| CD8+ T Cells% | 13–41 | 39.8 | 36.3 | 38.1 | 31.7 | 32.2 |
| CD8+ T Cells absolute (cells/μL) | 190–1140 | 116.2 | 137 | 223.8 | 197.3 | 234.3 |
| CD4: CD8 ratio | ≥1.0 | 0.9L | 0.8 | 0.6 | 0.7 | 0.7 |