CD4 and asthenia: We performed this study with two kids, a 13-year-old girl and a 6-year-old boy, called patient 1 and patient 2, respectively; both patients showed data to support a diagnosis of ALPS because of a recent history characterized by recurrent abdominal pain, asthenia, adynamia, jaundice and hepatosplenomegaly, in addition to leucopenia, thrombocytopenia, hemolytic anemia, negative ANA and anti-DNA antibodies, facial erythema, epistaxis and an increase in the number of double negative CD4/CD8 cells (Table 1).