Multi‐System Immunologically Mediated Disease: T Lymphocyte Deficiency and Thyroid Immunologic Disease—A Report of Four Cases

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Abstract
Four cases were described of multi-system immunologically-mediated disease (systemic lupus erythematosus (2 cases), polymyositis and sarcoidosis) in association with thyroid autoimmunity. In all patients there was evidence of T [thymus-derived] lymphocyte deficiency, namely poor response of peripheral blood lymphocytes (PBL) to T cell mitogens (4 cases) and failure or decreased ability to become sensitized to dinitrochlorobenzene (3 cases), although 2 patients were ill and 2 were being treated with steroids. There was also evidence of B [bone marrow-derived] lymphocyte deficiency since PBL of no patient responded normally to pokeweed mitogen, a B and T lymphocyte mitogen. In 2 patients there was evidence of cell-mediated immunity to human thyroid antigens. Although thyroid stimulating antibody was not detected in the 1 patient with Graves'' disease tested, significant titers of thyroid antibodies were detected in all cases. Possible relationships between T lymphocyte deficiency, organ-specific autoimmune disease and immunologically-mediated multi-system disorders were discussed.