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Lymphogranuloma venereum proctocolitis: mucosal T cell immunity of the rectum associated with chlamydial clearance and clinical recovery
  1. C van Nieuwkoop1,
  2. J Gooskens2,
  3. V T H B M Smit3,
  4. E C J Claas4,
  5. R A van Hogezand5,
  6. A C M Kroes6,
  7. F P Kroon7
  1. 1Leiden University Medical Center, Department of Infectious Diseases, Leiden, Netherlands
  2. 2Leiden University Medical Centre, Department of Medical Microbiology, Leiden
  3. 3Leiden University Medical Centre, Department of Pathology, Leiden
  4. 4Leiden University Medical Centre, Department of Medical Microbiology, Leiden
  5. 5Leiden University Medical Centre, Departments of Gastroenterology and Hepatology, Leiden
  6. 6Leiden University Medical Centre, Departments of Medical Microbiology, Leiden
  7. 7Leiden University Medical Centre, Departments of Infectious Diseases, Leiden
  1. Correspondence to:
    Dr C van Nieuwkoop
    Leiden University Medical Centre, Department of Infectious Diseases, C5-P, PO Box 9600, 2300 RC Leiden, Netherlands; c.van_nieuwkoop{at}

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Lymphogranuloma venereum (LGV) is a sexually transmitted disease caused by Chlamydia trachomatis serovars L1 to L3. At present there is an epidemic of LGV proctitis in the Western world among men who have sex with men. HIV seropositivity and other sexual transmitted infections are the main risk factors.1 Moreover, a concurrent HIV infection seems to be associated with a more severe course of LGV proctitis, indicating that LGV may behave as an opportunistic infection.2,3 Animal studies have shown a predominant role of CD4 lymphocytes in clearing chlamydial infection, including LGV proctitis, but knowledge of the human rectal immune response in LGV is limited.4–6 This is the first report of a patient with T cell immunodeficiency describing the rectal immunopathological response during prolonged LGV proctocolitis.

In April 2005, a 33 year old man was referred to our clinic because of resistant Crohn’s disease despite treatment with sulfasalazine, corticosteroids, and azathioprine. The patient was known to …

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  • Conflict of interest: none declared.