The Research On Cell And Humor Immunologic Derangement In Patients With Graves Disease

Objective:The present study was to investigate the mechanisms of immunologic injury in patients with Graves' disease(GD),especially in patients accompanied with exophthalmos,hypoleukemia,hepatic lesion,positive antinuclear antibody(ANA).Methods:Patients with GD and normal subjects were enrolled in this study.Patients with GD were divided into four groups:Graves's ophthalmopathy(GO) group and non-GO group,hypoleukemia group and non-hypoleukemia group,hepatic lesion group and non-hepatic lesion group,ANA positive group and ANA negative group. Percentage of CD3+ to total lymphocytes was measured through flow cytometry,so were the percentages of CD4+ and CD8+ to T lymphocytes;ANA was measured through immumofluorescence method;The concentration of IgG,IgA,IgM,C3,C4 were measured through ELISA.Results:(1) The level of IgG were higher than that in normal group(P＜0.05); C3,C4 were significantly lower than that in the normal(P＜0.01);IgA,IgM were not significantly different from normal group(P＞0.05).The percentage of CD3+,CD4+, CD8+ to total lymphocytes in GD group was not significantly different from normal group(P＞0.05);The ratio of CD4+/CD8+ in GD were higher than that in the normal (P＜0.05).(2) IgG,IgM were higher in the GO group than those in the non-GO group, but there were no significance(P＞0.05);IgA,C3 and C4 were lower in the GO group than those in the non-GO group,but there were also no significance(P＞0.05);There was no significance between GO group and non-GO group in the percentage of CD3+ to total lymphocytes and CD8+to T lymphocytes(P＞0.05).(3)The level of IgG,IgA, IgM,C3,C4 between hypoleukemia group and non-hypoleukemia group were not significantly different from normal group(P＞0.05);The percentage of CD3+ to T lymphocytes in hypoleukemia group was lower than that in the non-hypoleukemia group(P＞0.05);Both of the the percentage of CD4+ and the ratio of CD4+/CD8+ in the hypoleukemia group were lower than those in the non-hypoleukemia group(P＞0.05).(4) The level of IgA was higher in the hepatic lesion group than those in the non-hepatic lesion group(P＞0.05);The level of IgG,IgM,C3,C4 between hepatic lesion group and non-hepatic lesion group were not significantly different from normal group(P＞0.05);There was no significance between hepatic lesion group and non-hepatic lesion group in the percentage of CD3+,CD4+,CD8+ to T lymphocytes(P＞0.05).(5) The level of IgG were significantly higher in ANA positive group than those in ANA negative group(P＞0.05);Both of the level of IgA and IgM in the ANA positive group were higher than those in the ANA negative group(P＜0.05);There was no significance between ANA positive group and ANA negative group in the percentage of CD3+,CD4+,CD8+ to T lymphocytes(P＜0.05).(6) Incidence of ANA in GD was significantly higher than that in the normal group(P＞0.05);Nine(4.8%) cases had systemic autoimmune disorders(2 SLE,4 SS,3 myasthenia gravis).Conclusion:(1) The present study showed there was immunologic abnormality in patients with GD.Patients with GD accompanied with exophthalmos,hypoleukemia, hepatic lesion,positive ANA had even severe immunologic injury.(2) GD was systemic autoimmune disorders involved organs all over the body.Provide pathologic evidence for the use of glucocorticosteroid to treat GD.(3) GD often accompanies systemic autoimmune disorders.Detecting ANA has a great meaning to screen systemic autoimmune disorders,judge the severity of immunologic injury,guide immunotherapy and prevent the aggravation of pathogenetic condition.