Endocrine Abstracts

JOINT215

The purpose: of the study was to compare the hematological and immunological parameters of patients with Graves’ disease (GD) and autoimmune thyroiditis (AIT) when performing different volumes of surgical intervention.

Material and Methods: On 28 patients with GD and 36 patients with AIT with anemia performed total thyroidectomy (TT) and subtotal thyroidectomy (ST). HCB, RBC, HCT, MCV, MCH, MCHC, serum iron (Fe) and ferritin (Fr) were determined. Immune status was assessed by the level of CD3+, CD4+, CD8+, CD4+/CD8+, CIC, erythrophagocytosis, TRAb, TPOAb.

Results and discussion: Before surgery, more pronounced changes are observed in the group of patients with AIT statistically significant changes are noted in the level of MCV, MCH, Fe, Fr in comparison with the corresponding indicators of the group of patients with GD. Immune disorders expressed in immunodeficiency of the cellular component of immunity and activation of the humoral component, are observed in both groups of patients, only the level of CD4+ helper cells is significantly lower in patients with AIT (P <0.05). A year after ST, hematological disorders worsened in both groups of patients compared to controls. At the same time, in terms of the values of HGB, RBC and HCT indicators, both groups differ significantly from each other and more pronounced changes are observed in individuals with GD. A deterioration is also observed among indicators of immune status (CD3+, CD4+, CD4+/CD8+, CIC) and are more pronounced in patients with AIT (P <0.05). A year after TT, hematological parameters improved significantly in patients of both groups and were practically no different from the control group. Only the hematocrit level in individuals with AIT (37,9±0,4%)still differs from the corresponding indicator for controls and patients with GD (P <0.05). By this time, the immunological parameters of both groups had approached the control ones.

Conclusions: Although GD and AIT are autoimmune diseases with different clinical presentations and different mechanisms for the development of anemia, the results obtained are unidirectional. Performing TT in patients with GD and AIT with anemia leads to the cessation of the autoimmune process and improvement of hematological parameters against the background of euthyroidism, achieved through levothyroxine replacement therapy. The preservation of thyroid tissue during ST in both groups of patients apparently contributes to the further aggravation of autoimmune disorders and deterioration of hematological parameters, despite the euthyroid hormonal background of the patients.