Ishida S
First Department of Internal Medicine, Osaka Medical College.
Rinsho Shinkeigaku. 1996 May;36(5):629-32.
We report a detailed analysis of the clinical courses and the immunological examinations in seven patients with myasthenia gravis (MG) and invasive thymoma (Ossermann's type I: 3 cases, IIa: 1 case and IIb: 3 cases), who underwent a transsternal extended thymectomy and postoperative radiation therapy. Two patients with Ossermann's type IIb showed the deterioration of MG after the irradiation. Immunological examinations by an analysis of the subsets of peripheral blood lymphocytes demonstrated a significant decrease of the proportion in CD4 + CD45RA+ T (naive) cells and a significant increase in CD4 + CD45RA-(memory) T cells. Further, the percentage of activated (HLADR+) CD4T cell subsets were increased. The present study suggests that post-thymectomized irradiation may change the balance of the proportion in CD4+ T cell subsets, thereby resulting in the deterioration of MG.
我们报告了对7例重症肌无力（MG）合并侵袭性胸腺瘤（Ossermann I型：3例，IIa型：1例，IIb型：3例）患者的临床病程和免疫检查的详细分析，这些患者接受了经胸骨扩大胸腺切除术及术后放疗。2例Ossermann IIb型患者在放疗后出现MG病情恶化。通过对外周血淋巴细胞亚群分析进行的免疫检查显示，CD4 + CD45RA+ T（幼稚）细胞比例显著下降，CD4 + CD45RA-（记忆）T细胞比例显著增加。此外，活化的（HLADR+）CD4T细胞亚群百分比增加。本研究表明，胸腺切除术后放疗可能会改变CD4+ T细胞亚群比例的平衡，从而导致MG病情恶化。
