Immune-mediated diseases and immunodeficiencies associated with thymic epithelial neoplasms.
BACKGROUND
This retrospective study aimed to characterize the clinical hematological and immunological features of patients with thymic epithelial neoplasms.


METHODS
From a cohort of 512 patients with thymic epithelial neoplasms, 79 patients diagnosed with autoimmune/immunodeficiency conditions or signs and/or symptoms suggesting an autoimmune or immunodeficiency state were evaluated by standard immunological and hematological testing.


RESULTS
Elevated percentages of CD2+, CD3+, and CD8+ lymphocytes were observed in 44 (57.1%), 33 (41.8%), and 32 (40.5%) patients. Low CD4+ and CD19+ percentages were observed in 25 (31.6%) and 36 (46.2%), respectively; CD4+:CD8+ ratios were inverted in 18 (22.8%). IgG, IgA, and IgM levels were low in 12 (15.8%), 9 (11.7%) and 15 (19.7%) patients, respectively. Patients with immunodeficiency condition(s) were more likely to have high CD8+ percentages (p = 0.040), low CD19+ percentages (p = 0.025), and/or inverted CD4+/CD8+ ratios (p = 0.034). Patients with autoimmune condition(s) were more likely to have a high/normal CD4+ percentage (p = 0.038). High CD2+ percentages were associated with lower mean IgG and IgA levels (p = 0.030 and p = 0.017, respectively). High CD3+ and CD8+ percentages were associated with lower mean IgA levels (p = 0.046 and p = 0.013, respectively). Low CD19+ percentages were associated with lower mean IgG and IgA levels (p = 0.004 and p < 0.001, respectively).


CONCLUSIONS
Signs/symptoms and history of autoimmune and immunodeficiency conditions among patients with thymic epithelial neoplasms are associated with high frequencies of abnormalities in immunoglobulin levels and lymphocyte immunophenotypes, suggesting a role for their assessment.
Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA.
Muhammad Rizwan
MR
Khawaja
Robert P
RP
Nelson
Nicholas
N
Miller
Sunil S
SS
Badve
Elizabeth
E
Loehrer
Magdalena
M
Czader
Susan M
SM
Perkins
Kenneth
K
Kesler
Patrick J
PJ
Loehrer
D000293:Adolescent; D000328:Adult; D000368:Aged; D015703:Antigens, CD / Q000276:immunology; D001327:Autoimmune Diseases / Q000097:blood / Q000276:immunology*; D005260:Female; D006801:Humans; D007136:Immunoglobulins / Q000097:blood; D007153:Immunologic Deficiency Syndromes / Q000097:blood / Q000276:immunology*; D008214:Lymphocytes / Q000276:immunology; D008297:Male; D008875:Middle Aged; D009375:Neoplasms, Glandular and Epithelial / Q000097:blood / Q000276:immunology*; D012189:Retrospective Studies; D013953:Thymus Neoplasms / Q000097:blood / Q000276:immunology*; D055815:Young Adult
D015703:Antigens, CD; D007136:Immunoglobulins