Immunological system status and the appearance of respiratory system disturbances in thymectomized patients.
BACKGROUND
Adult-onset thymoma may be responsible for several diseases, such as pure red cell aplasia, myasthenia gravis, and immunodeficiency (Good's syndrome). Thymectomy does not always improve the patient's condition, and may even produce additional symptoms. Its pathogenesis is still not entirely understood, but autoimmunological processes and bone marrow defect are the most frequently suggested.


METHODS
Eleven patients (mean age: 56.2+/-15.5 years) were analyzed 6 months to 10 years after thymectomy due to thymoma as were 25 healthy persons serving as controls. Enzyme-linked immunosorbent assay (ELISA) and flow cytometry techniques were used to evaluate the immunological status of the subjects.


RESULTS
Good's syndrome was diagnosed in one patient, 4 subjects suffered from myasthenia gravis, and recurrent infections of upper and lower respiratory tract appeared in 9 patients. The immunological analyses (ELISA and flow cytometry) revealed a significantly lower IgG level (p<0.05), percentage of peripheral blood B lymphocytes (p<0.0005), and CD4:CD8 ratio (p<0.05) in thymectomized patients compared with the healthy controls. The percentages of CD4+ and CD8+ T lymphocytes expressing CD28 antigen were significantly lower in thymectomized patients than in healthy subjects (p<0.005 and p<0.01, respectively). The percentage of naive T helper lymphocytes was significantly lower in the patients than in the control group (p<0.05).


CONCLUSIONS
Immunodeficiency and recurrent infections may be the first symptoms of immunological disturbances after thymectomy in adults. It is suggested that regular medical monitoring of these patients is important in preventing further complications, which may result in irreversible lung tissue destruction.
Krawczyk
Paweł
P
Department of Pneumonology, Oncology, and Allergology, Medical University of Lublin, Poland. pulm.dept@am.lublin.pl
Adamczyk-Korbel
Marta
M
Kieszko
Robert
R
Korobowicz
Elzbieta
E
Milanowski
Janusz
J
D000328:Adult; D000368:Aged; D004198:Disease Susceptibility / Q000276:immunology*; D005260:Female; D006801:Humans; D007153:Immunologic Deficiency Syndromes / Q000175:diagnosis / Q000276:immunology; D008297:Male; D008875:Middle Aged; D009157:Myasthenia Gravis / Q000175:diagnosis / Q000276:immunology; D012140:Respiratory Tract Diseases / Q000175:diagnosis* / Q000276:immunology*; D012141:Respiratory Tract Infections / Q000175:diagnosis / Q000276:immunology; D013934:Thymectomy / Q000009:adverse effects*