Lymphogranuloma venereum proctocolitis: mucosal T cell immunity of the rectum associated with chlamydial clearance and clinical recovery

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 …