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

A case of Evans' syndrome with IgM deficiency and lymphopenia was studied b efore and after splenectomy. The lymphopenia was as a result of profound re duction of CD4 and CD8 cells. Study of cytokine secretion before splenectom y revealed a spontaneous Th1- and Th2-type cytokine production, and complet e suppression of transforming growth factor (TGF)-beta. After splenectomy, the patient achieved clinical remission, the natural killer (NK) cell numbe r increased and the pattern of cytokine production showed normalization of interleukin (IL)-2, IL-4, IL-10, TGF-beta and abolition of interferon (IFN) -gamma production. We conclude that splenectomy had a beneficial effect owi ng to an increase in NK cells and an associated increase in TGF-beta produc tion.