Delayed Hypersensitivity in Graves' Disease¹

Abstract

This clinical study evaluated the delayed hypersensitivity response in 11 Graves' disease and 56 control patients by intradermal skin testing, application of dinitrochlorobenzene (DNCB) and assessment of the ability of the inflammatory response by challenge with a cutaneous irritant, croton oil. All Graves' disease patients reacted to at least one intradermal skin test (SK/SD, mumps, Trichophyton, Candida, PPD) with 5 mm or more of induration, 73% reacted to at least one intradermal test with 10 mm or more of induration, and two patients reacted with 10 mm or more induration to 3 of 5 tests administered. All Graves' disease patients exhibited a positive response to croton oil and all exhibited a 2+ or greater response to DNCB sensitization. There was no significant difference (p < 0.01) in reactivity between the control group and Graves' disease patients. Although this study indicates that there is no apparent alteration in delayed hypersensitivity in Graves' disease patients, this does not contradict the current hypothesis that a specific defect in immunologic surveillance may be a key factor in the pathogenesis of this disease state. However, the measurement of delayed hypersensitivity by intradermal skin testing or contact sensitization appears not to aid in the elucidation of such a defect.