Advances in Clinical and Experimental Medicine

Title abbreviation: Adv Clin Exp Med
JCR Impact Factor (IF) – 2.1
5-Year Impact Factor – 2.2
Scopus CiteScore – 3.4 (CiteScore Tracker 3.4)
Index Copernicus  – 161.11; MEiN – 140 pts

ISSN 1899–5276 (print)
ISSN 2451-2680 (online)
Periodicity – monthly

Download original text (EN)

Advances in Clinical and Experimental Medicine

2017, vol. 26, nr 2, March-April, p. 237–243

doi: 10.17219/acem/61004

Publication type: original article

Language: English

Download citation:

  • BIBTEX (JabRef, Mendeley)
  • RIS (Papers, Reference Manager, RefWorks, Zotero)

The coexistence of autoimmune rheumatic diseases and thymomas

Ying Jiang1,A,B,D, Xiaodan Dai1,B,C, Liping Duan1,B,E, Yaou Zhou1,A,F

1 Department of Rheumatology and Clinical Immunology, Xiangya Hospital, Central South University, Changsha, Hunan, China

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.
Conclusion. 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.

Key words

autoimmune rheumatic diseases, thymoma, PRCA, thymectomy

References (29)

  1. Goldblatt F, O’Neill SG. Clinical aspects of autoimmune rheumatic diseases. Lancet. 2013;382(9894):797–808.
  2. Shelly S, Agmon-Levin N, Altman A, Shoenfeld Y. Thymoma and autoimmunity. Cell Mol Immunol. 2011;8(3):199–202.
  3. Strobel P, et al. Thymoma and thymic carcinoma: An update of the WHO Classification 2004. Surg Today. 2005;35(10):805–811.
  4. Mejri N, Chabchoub I, Gargouri I. Effect of chemotherapy on autoimmune hepatitis in thymoma: A case report and literature review. Cancer Biol Med. 2013;10(3):169–173.
  5. Simeone JF, McCloud T, Putman CE, Marsh J. Thymoma and systemic lupus erythematosus. Thorax. 1975;30(6):697–700.
  6. Steven MM, Westedt ML, Eulderink F, Hazevoet HM, Dijkman JH, Cats A. Systemic lupus erythematosus and invasive thymoma: Report of two cases. Ann Rheum Dis. 1984;43(6):825–828.
  7. Ben-Shahar M, Rosenblatt E, Green J, Cohen I. Malignant thymoma associated with progressive systemic sclerosis. Am J Med Sci. 1987, 294(4), p. 262267.
  8. Parakova Z, Hrncir Z, Nozicka Z. Thymoma in the anterior mediastinum and systemic lupus erythematosus. Vnitr Lek. 1992;38(2):177–183.
  9. Menon S, Snaith ML, Isenberg DA. The association of malignancy with SLE: An analysis of 150 patients under long-term review. Lupus. 1993;2(3):177–181.
  10. Sakuragi T, Furukawa T, Yonemura T, Yoshida T, Irie K. Thymoma associated with progressive systemic sclerosis: A case report. Nihon Kyobu Geka Gakkai Zasshi. 1995;43(1):135–138.
  11. Zandman-Goddard G, Lorber M, Shoenfeld Y. Systemic lupus erythematosus and thymoma: A double-edged sword. Int Arch Allergy Immunol. 1995;108(1):99–102.
  12. Duchmann R, Schwarting A, Poralla T, Meyer zum Büschenfelde KH, Hermann E. Thymoma and pure red cell aplasia in a patient with systemic lupus erythematosus. Scand J Rheumatol. 1995;24(4):251–254.
  13. Matsumoto Y, Hirai S, Ohashi M, Imaizumi M. Sjogren’s syndrome associated with thymoma. J Am Acad Dermatol. 1996;35(4):639–640.
  14. Ago T, Nakamura M, Iwata I, et al. Dermatomyositis associated with invasive thymoma. Intern Med. 1999;38(2):155–159.
  15. Bozzolo E, Bellone M, Quaroni N, Voci C, Sabbadini MG. Thymoma associated with systemic lupus erythematosus and immunologic abnor-malities. Lupus. 2000;9(2):151–154.
  16. Boonen A, Rennenberg R, van der Linden S. Thymoma-associated systemic lupus erythematosus, exacerbating after thymectomy. A case report and review of the literature. Rheumatology (Oxford). 2000;39(9):1044–1046.
  17. Lin YC, Wu CC, Ou TT, Yen JH, Liu HW, Tsai WC. Malignant thymoma associated with mixed connective tissue disease: A case report. Clin Rheumatol. 2006;25(2):262–264.
  18. Tsai Y, Lin Y, Chen C, Tzao C. Thymoma associated with myasthenia gravis and Sjogren syndrome. West Indian Med J. 2013;62(3):264–265.
  19. Marmont AM, Bacigalupo A, Gualandi F, Bregante S, van Lint MT, Geroldi S. Systemic lupus erythematosus complicated with thymoma and pure red cell aplasia (PCRA): CR of both complications following thymectomy and allogeneic haematopoietic SCT (HSCT), but persistence of antinuclear antibodies (ANA). Bone Marrow Transplant. 2014;49(7):982–983.
  20. Zou L, Xiong Z, Dun Y, Xiong Y. A case of rheumatoid arthritis associated with Hashimoto’s thyroiditis and thymoma. Int J Rheum Dis. 2014. doi: 10.1111/1756-185X.12453.
  21. Chintakuntlawar AV, Rizvi SA, Cassivi SD, Pardanani A. Thymoma-associated pancytopenia: Immunosuppressive therapy is the cornerstone for durable hematological remission. Ann Hematol. 2015; 94(3):453–458.
  22. Habib GS, Saliba WR, Froom P. Pure red cell aplasia and lupus. Semin Arthritis Rheum. 2002;31(4):279–283.
  23. Koyama, RV, Silva LF, Henriques VB, Tran C, Yoshikawa GT. Pure red cell aplasia associated with systemic lupus erythematosus. Acta Reumatol Port. 2014;39(3):265–268.
  24. Fallahi S, Akbarian M, Dabiri S. Pure red cell aplasia as a presenting feature in systemic lupus erythematosus and association with thymoma, hypothyroidism and hypoparathyroidism: A case report and literature review. Iran J Allergy Asthma Immunol. 2014;13(2): 138–143.
  25. Mankia S, Giles IP. Pure red cell aplasia in a patient with lupus-like disease and thymoma. Grand Rounds. 2011;11(1):37–40.
  26. MacKechnie HL, Squires AH, Platts M, Pruzanski W. Thymoma, myasthenia gravis, erythroblastopenic anemia and systemic lupus erythema-tosus in one patient. Can Med Assoc J. 1973;109(8):733–738.
  27. Iwadate H, Kobayashi H, Shio K, et al. A case of systemic lupus erythematosus complicated by pure red cell aplasia and idiopathic portal hypertension after thymectomy. Mod Rheumatol. 2006;16(2): 109–112.
  28. Rosman A, Atsumi T, Khamashta MA, Ames PR, Hughes GR. Development of systemic lupus erythematosus after chemotherapy and radio-therapy for malignant thymoma. Br J Rheumatol. 1995;34(12): 1175–1176.
  29. Gupta RK, Ezeonyeji AN, Thomas AS, Scully MA, Ehrenstein MR, Isenberg DA. A case of pure red cell aplasia and immune thrombocytopenia complicating systemic lupus erythematosus: Response to rituximab and cyclophosphamide. Lupus. 2011;20(14):1547–1550.