Adalimumab reversed a severe lymphopenia in a patient with Crohn's disease.

Patients with Crohn's disease are frequently found to have low peripheral lymphocyte counts. Lymphopenia has been linked to disease activity, the effects of therapy and the presence of an abnormal T regulatory (T(reg)) function. We present a patient with Crohn's disease and a severe total and CD4 lymphopenia that did not resolve after discontinuation of immunosuppressive treatment and resective surgery. Complete clinical remission and persistent normal levels of total and CD4 lymphocytes were observed after starting therapy with the anti-tumor necrosis factor monoclonal antibody adalimumab.