Hyperglobulinæmic Purpura Due to a Thymic Tumour

A serological study of primary thymic neoplasms.

“…The clinical response in myasthenia gravis is poor (Henson, Stern, and Thompson, 1965), and no changes in serum y-globulin levels occur, after treatment of thymoma associated with hypo-y-globulinaemia (Gafni et al, 1960;Wollheim, Belfrage, Coster, and Lindholm, 1964). Nor has thymectomy affected serological evidence of autoimmune phenomena in the occasional case reported, even in the presence of a good clinical response (Birch, Cooke, Drew, London, Mackenzie, and Milne, 1964). It remains a possibility, however, that the treatment which all but one of the present patients had had prior to this study affected the serological findings.…”

Paraproteinæmia [Abridged]

“…In many cases the level remained constant for 3-6 years. In one of our cases of Henoch-Schonlein purpura (Birch et al 1964) the paraprotein disappeared after removal of a benign thymoma and never recurred.…”

Purpura hyperglobulinaemia in association with rheumatoid arthritis and ulcerative colitis

“…Henoch's purpura is acknowledged to be predominantly a male condition and, perhaps in keeping with the frequency of preceding infection (Kreidberg, Dameshek & Latarroea, 1955) often of streptococcal type, all authors are now agreed that nephritis occurs in 40-60% of cases (Heptinstall, 1960) and furthermore that this condition may be a generalized vasculitis. Apart from the possibility of acute tubular necrosis in purpura hyperglobulinaemia as in the case of Birch et al (1964) and, as reported by Waldenstrom (1961), acute renal failure in a patient whose condition progressed into an SLE-like condition, other authors do not mention a glomerulo-nephritis associated with purpura hyperglobulinaemia. This may merely be a reflection of the paucity of cases for both Henoch-Schonlein purpura and purpura hyperglobulinaemia might be expected to be conditions in which there are at times circulating antigen-antibody complexes.…”

“…Strauss (1959) in a review of seventy-two cases points to the association with unexplained * At present: Senior Medical Registrar, The Royal Victoria Infirmary, Newcastle upon Tyne 1. enlargement of the liver and spleen, with arthritis and Sjogren's syndrome and with intestinal symptoms, but so far there has been no report of the occurrence of ulcerative colitis. Birch et al (1964) reported a case with a benign thymoma, removal of which resulted in remission of the purpura but the latex fixation and Rose-Waaler tests then became positive.…”