Imbalances of t-cells in thymoma-associated hypogammaglobulinemia

J Jager, M. van der Giessen, L. H. van Essen, S. Poppema, C. G. Kallenberg

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    The case is described of a 74-year-old man with severe diarrhoea and late-onset hypogammaglobulinaemia associated with spindle-cell thymoma. Plasma cells and B-lymphocytes were absent in the peripheral blood, bone marrow and lymphoid tissue with the exception of the gut. Functional studies revealed impaired in-vitro cellular immunity with a reversed ratio of T4 T8-reactive cells. After depletion of T8-reactive cells, the mitogen-induced lymphocyte proliferative response increased to median normal values. Infiltration of T8 positive cells was also noted in the thymus. Normal thymocytes (T4-, T6-, T8-reactive) were hardly present, whereas clustering of T8-reactive cells was associated with expression of class II MHC antigens on epithelial thymoma cells. Thymectomy and gamma-globulin substitution resulted in the disappearance of diarrhoea and respiratory infections, but did not influence the reversed T4 T8 ratio. The possible implications of these findings are discussed.
    Original languageEnglish
    Pages (from-to)118-125
    Number of pages8
    JournalNetherlands Journal of Medicine
    Issue number4
    Publication statusPublished - Feb-1986

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