Th1 and Th2 cytokines in a patient with Evans' syndrome and profound lymphopenia

Abstract

A case of Evans' syndrome with IgM deficiency and lymphopenia was studied before and after splenectomy. The lymphopenia was as a result of profound reduction of CD4 and CD8 cells. Study of cytokine secretion before splenectomy revealed a spontaneous Th1- and Th2-type cytokine production, and complete suppression of transforming growth factor (TGF)-β. After splenectomy, the patient achieved clinical remission, the natural killer (NK) cell number increased and the pattern of cytokine production showed normalization of interleukin (IL)-2, IL-4, IL-10, TGF-β and abolition of interferon (IFN)-γ production. We conclude that splenectomy had a beneficial effect owing to an increase in NK cells and an associated increase in TGF-β production.