In this group we reported the most remarkable CD4+ T cell increase from nadir to TD diagnosis (mean CD4+ increase: 437.54 ± 306.13), supporting the previously described hypothesis of Graves’ disease as a manifestation of delayed immune reconstitution inflammatory syndrome (IRIS)21,22 and suggesting that some CD4+ T lymphocytes subsets may affect its occurrence40. This evidence concerns the gene CD4 and Graves disease.