The coexistence of autoimmune rheumatic diseases and thymomas

Adv Clin Exp Med. 2017 Mar-Apr;26(2):237-243. doi: 10.17219/acem/61004.

Abstract

Background: Autoimmune rheumatic diseases (ARDs), involving immune disturbances resulting from auto-inflammatory mechanisms, are a group of diseases characterized by autoimmunity and autoimmunemediated organ damage. Thymoma, whose mechanism is also associated with immune abnormalities, is the most common neoplasm of the anterior mediastinum. But thymoma with ARDs is relatively less frequent. The clinical characteristics of the coexistence of ARDs and thymomas are still not very clear. And the therapeutic strategy for ARDs combined with thymomas varies, with an uncertain outcome.

Objectives: The aim of this study was to investigate the clinical characteristics of the coexistence of ARDs and thymomas in order to speculate whether a thymectomy is effective for ARDs combined with thymomas, and to seek the proper therapeutic strategy for treating ARDs combined with thymomas.

Material and methods: We presented 2 cases of the coexistence of ARDs and thymomas. Then, we summarized 20 cases (including our 2 cases) in which the ARD was diagnosed concurrently with, or prior to, the thymoma.

Results: Pure red cell aplastic anemia (PRCA) might be associated with an ARD and a thymoma, and a thymectomy may lead to the appearance, exacerbation, or remission of ARDs.

Conclusions: Searching for a thymoma is necessitated if a patient with ARDs experiences PRCA and the effects of thymectomy in ARDs combined with thymomas may be associated with the onset sequence of ARDs and thymomas.

Keywords: PRCA; autoimmune rheumatic diseases; thymectomy; thymoma.

Publication types

  • Case Reports

MeSH terms

  • Autoimmune Diseases / complications*
  • Autoimmune Diseases / diagnosis
  • Autoimmune Diseases / therapy
  • Female
  • Humans
  • Middle Aged
  • Review Literature as Topic
  • Rheumatic Diseases / complications*
  • Rheumatic Diseases / diagnosis
  • Rheumatic Diseases / therapy
  • Thymectomy / methods
  • Thymoma / complications*
  • Thymoma / diagnosis
  • Thymoma / surgery
  • Thymus Neoplasms / complications*
  • Thymus Neoplasms / diagnosis
  • Thymus Neoplasms / surgery
  • Treatment Outcome