AUTOIMMUNE AND HEMATOLOGICAL STATUS OF GRAVES’ DISEASE PATIENTS

F. Saidova, J. Aslanova, L. Ahmedova, О.М. Shahsuvarov
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Abstract

Purpose of the study: comparative assessment of hematological and autoimmune status of patients with Graves’ disease (GD). Materials and methods. 43 GD patients aged between 19 and 64 years, 26 of which were women and 17 were men, have been examined. Assessment of hemograms of examined patients helped to reveal anemia in 28(65.1%) examined patients (group I). In 15 (34.9%) patients (group II) anemia was not detected. Mild anemia was diagnosed in 25 (89.3%), moderate anemia – in 3 (10.7%) patients. Hemoglobin, hematocrit, erythrocyte count and erythrocyte indices MCV, MCH, MCHC, serum Fe and ferritin status was chaecked in clinical analysis. The immune status was assessed by the level of CD3+, CD4+, CD8+, CD19+, CD4+/CD8+, CEC, Ef, TSHRAb and hormonal status by the level of TSH, T4 free. Results. Microcytic anemia was determined in 15 (53.6%) patients, normocytic - in 12 (42.8%), macrocytic - in 1 (3.5%) patient due to volume of erythrocytes’ MCV. According to morphological criteria of МСН (mean content of hemoglobin in erythrocyte) anemia hypochromic type of anemia was noted in 15 (53.6%) patients, normochromic - in 12 (42.8%), hyperchromic - in 1 (3.5%) patient. In 15 (53.6%%) patients in the group I microcytic - hypochromic anemia was diagnosed, which is characteristic for iron-deficient anemia; in 12 (42.8%) patients was verified normocyticnormochromic anemia, which has morphological parameters of anemia of chronic diseases and in 1 (3.5%) patient macrocytic-hyperchromic anemia. Comparative assessment of HGB level and indicators of iron metabolism in GD patients with anemia detected decreasing of HGB by 20%, serum Fe by 20%, ferritin by 29% compared to the corresponding control values. More pronounced depletion of the iron depot (ferritin) due to the fact that the development of anemia is preceded by a “latent iron deficiency”, an indicator of which is ferritin. Conclusions. GD is characterized by high frequency of anemia (65.1%), mostly mild form (89.3%), microcytichypochromic (53.6%), characteristic of iron deficiency anemia. The severe hematological disorders, detected among GD patients with anemia are accompanied by deep autoimmune changes and hyperfunction of the thyroid gland.
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graves病患者自身免疫及血液学状况
研究目的:比较评估Graves病(GD)患者的血液学和自身免疫状态。材料和方法。43例GD患者,年龄19 ~ 64岁,其中女性26例,男性17例。ⅰ组28例(65.1%)检测到贫血,ⅱ组15例(34.9%)未检出贫血。轻度贫血25例(89.3%),中度贫血3例(10.7%)。临床分析检查血红蛋白、红细胞压积、红细胞计数及红细胞指标MCV、MCH、MCHC、血清铁、铁蛋白状态。以CD3+、CD4+、CD8+、CD19+、CD4+/CD8+、CEC、Ef、TSHRAb水平评价免疫状态,以TSH、T4 free水平评价激素状态。结果。根据红细胞MCV的测定,小细胞性贫血15例(53.6%),常细胞性贫血12例(42.8%),巨细胞性贫血1例(3.5%)。根据МСН(红细胞平均血红蛋白含量)的形态学标准,低色型贫血15例(53.6%),正色型贫血12例(42.8%),高色型贫血1例(3.5%)。15例(53.6%)的患者被诊断为小细胞-低色素贫血,这是缺铁性贫血的特征;12例(42.8%)确诊为正细胞-正色性贫血,具有慢性病贫血的形态参数;1例(3.5%)确诊为巨细胞-高色性贫血。GD合并贫血患者HGB水平及铁代谢指标对比评估发现,与相应对照值相比,HGB下降20%,血清铁下降20%,铁蛋白下降29%。更明显的铁库(铁蛋白)耗竭是由于在贫血发生之前存在“潜在缺铁”这一事实,铁蛋白是其指标之一。结论。GD的特点是高频率贫血(65.1%),多为轻度贫血(89.3%),微红细胞染色(53.6%),以缺铁性贫血为特征。GD合并贫血患者中发现的严重血液学疾病伴有深层自身免疫改变和甲状腺功能亢进。
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