Analysis of the clinical profile, autoimmune phenomena and T cell subsets ( XXXX and @entity405 ) in @entity12040 : a hospital-based study.

@entity1 @entity227 @entity404 @entity101 @entity4218 @entity14525 @entity9500 @entity12040 @entity1200 @entity854 @entity792 @entity490 @entity1499 @entity10 @entity405 @entity617
OBJECTIVE: To evaluate clinical and @entity1200 in @entity1 with @entity12040 ( @entity12040 ) from India, with particular reference to autoimmune perturbations and @entity854 cell subsets ( @entity404 and @entity405 cells). METHODS: 16 consecutive @entity1 with @entity12040 (11 females and 5 males) underwent clinical and laboratory evaluation inclusive of flow cytometric analysis of T cell subsets ( @entity404 and @entity405 ). A control population of 94 age- and sex-matched blood donors was used to determine the normal T cell subsets. Student's t-test was used to compare the means. RESULTS: The mean age at onset was 23.4 + 2.3 yrs. Common symptoms observed were @entity10 , @entity4218 , @entity490 and @entity227 . Common clinical signs observed included reduced arterial pulsations, bruits, and a BP difference > 10 mm Hg in the upper limbs. Systemic @entity101 was documented in 12 @entity1 . The mean absolute lymphocyte count in the @entity1 was 2289/mm3. The mean @entity404 count and @entity404 % were 1003 and 41 respectively; the mean @entity405 count and @entity405 % were 755 and 34, respectively; and the mean @entity14525 ratio was 1.41. The @entity1 had statistically significantly higher @entity405 but not @entity404 T cell values than controls. IgG and IgM immunoglobulin levels were increased. The mean multi-test CMI score in @entity1 using CMI multi-test device of Pasteur Merieux was 14.6 mm. Two @entity1 had an anergic response, 4 a partial response (1-13 mm), and 6 a full response of > 13 mm. Four @entity1 hyper-responded with a score of > 20 mm. ANCA was positive in 2 @entity1 . ANA was positive in 3 patients. IgG anticardiolipin was positive in 12 @entity1 and IgM in 3; overall 12 patients were anticardiolipin positive by ELISA. Anti- @entity9500 of the IgG variety was found to be positive in 3 @entity1 and IgM in 2 @entity1 ; overall 3 @entity1 being positive for the same. Nine of the @entity1 with active disease were started on a combination of moderate dose @entity617 (20-40 mg once daily) along with weekly oral @entity1499 (7.5-15.0 mg). Surgical intervention was required in 6 @entity1 . CONCLUSION: This study found an increase in @entity405 positive T cell subsets, increased IgG and IgM immunoglobulin levels, and the presence of autoantibodies including ANA, ANCA, anticardiolipin and anti- @entity9500 antibodies in @entity12040 @entity1 . @entity12040 may be an @entity792 with T cell aberrations. The relationship with antiphospholipid antibodies and anti- @entity9500 needs to be explored and confirmed by other larger studies. The strikingly positive responses to tuberculin, as well as the multi-test CMI also indicate exaggerated T cell responses and cell mediated immunity in @entity12040 . Immunosuppressive therapy was successful in controlling disease activity in the majority, but surgery was needed for irreversible stenotic lesions.
