Autoimmune and Hematological Status of Graves’ Disease Patients

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.