A client has just been diagnosed with Graves disease. The primary care provider tells the client that this is due to the presence of autoantibodies to the TSH receptor. The client asks the nurse to explain this in simpler terms
Which response would be the best for this client?
A) "Hyperthyroidism is basically an autoimmune disorder."
B) "Basically your lymph node system has gone haywire."
C) "Your body has loss its ability to delete autoreactive T cells in the thyroid."
D) "The filtration system in your body is no longer working."
Ans: A
Feedback:
Several mechanisms are available to filter autoreactive B cells out of the B-cell population: clonal deletion of immature B cells in the bone marrow; deletion of autoreactive B cells in the spleen or lymph nodes; functional inactivation or anergy; and receptor editing, a process that changes the specificity of a B-cell receptor when autoantigen is encountered. There is increasing evidence that B-cell tolerance is predominantly due to help from T cells. Loss of self-tolerance with development of autoantibodies is characteristic of a number of autoimmune disorders. For example, hyperthyroidism in Graves disease is due to autoantibodies to the TSH receptor.
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