Recurrent neutropenia and chronic diarrhea following thymectomy: the good, the bad, and the ugly

Oyenuga, Mosunmoluwa; Shaikh, Safia; Harris, Benjamin; Sinha, Jyotsana; Lacasse, Alexandre

doi:10.1080/20009666.2021.1877400

Cited by 3 publications

(2 citation statements)

References 17 publications

(22 reference statements)

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“…His blood work showed only PWCA and immune thrombocytopenia, with no evidence of hypogammaglobulinemia. Although most previous case reports have described PWCA at the time of thymoma diagnosis, our patient's first evidence of neutropenia first developed 2-weeks postthymectomy [ 17 ]. Here, we have reviewed and summarized several case reports for PWCA associated with thymoma ( Table 2 ).…”

Section: Discussionmentioning

confidence: 88%

Pure White Cell Aplasia and Immune Thrombocytopenia after Thymoma Resection: A Case Report and Review of the Literature

Youssef

Stratton

Gallant

et al. 2022

Case Reports in Hematology

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We report a case of pure white cell aplasia (PWCA) postthymoma resection in a 74-year-old male presenting with a 2-week history of fevers, night sweats, and severe febrile neutropenia. His pure white cell aplasia was treated with intravenous immunoglobulin (IVIg), granulocyte colony-stimulating factor (G-CSF), prednisone, and cyclosporine with a mixed response. He also developed immune thrombocytopenia, which responded well to a short course of eltrombopag. With continued cyclosporine treatment, his platelet counts were stable after stopping eltrombopag. The patient's cyclosporine treatment was complicated by renal failure, resulting in cessation of cyclosporine. His PWCA and immune thrombocytopenia significantly worsened after stopping cyclosporine, and unfortunately, he died from multiorgan failure and sepsis.

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Section: Discussionmentioning

confidence: 88%

Pure White Cell Aplasia and Immune Thrombocytopenia after Thymoma Resection: A Case Report and Review of the Literature

Youssef

Stratton

Gallant

et al. 2022

Case Reports in Hematology

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“…In addition to concurrent paraneoplastic anemias, the patient also developed neutropenia and thrombocytopenia. Hypothesized etiologies for the neutropenia and thrombocytopenia included an occult presentation of T-LGLL causing cytopenias versus thymoma-associated neutropenia and thrombocytopenia, though the latter is extremely rare [ 4 , 27 , 28 ]. In contrast, the relationship between T-LGLL and immune-mediated cytopenias is well described in the literature [ 29 ].…”

Section: Discussionmentioning

confidence: 99%

Thymoma With Triple Threat: Pure Red Cell Aplasia, Autoimmune Hemolytic Anemia, and T-Cell Large Granular Lymphocytic Leukemia

2022

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Thymomas are a rare neoplasm of the anterior mediastinum and often associated with paraneoplastic syndromes. Though myasthenia gravis is the most common and well-known, the list of reported paraneoplastic syndromes occurring with thymoma is extensive and ever-growing. Paraneoplastic syndromes can involve nearly every organ system, including hematologic abnormalities affecting any or all cell lines. This can present challenges to the clinician in terms of diagnosis, prognostic impact, and management. We present the case of a previously healthy 41-year-old female who was diagnosed with thymoma and three rare hematologic paraneoplastic syndromes: pure red cell aplasia (PRCA), autoimmune hemolytic anemia (AIHA), and T-cell large granular lymphocytic leukemia (T-LGLL). To the best of our knowledge, there have been only four other reported cases of PRCA and AIHA in a single patient with thymoma, all of which were treated with thymectomy. Upfront surgical resection was not possible in the present case and thus the patient was alternatively treated with corticosteroids and octreotide, which proved successful in resolving the anemia. The authors present this case to share these findings of an alternative treatment strategy for thymoma-associated PRCA and AIHA and to highlight the importance of careful monitoring with routine blood work for these complex patients.

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A case of resection of type B1 thymoma with neutropenia

Ohashi

Kitami

Suzuki

et al. 2022

The Journal of the Japanese Association for Chest Surgery

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Recurrent neutropenia and chronic diarrhea following thymectomy: the good, the bad, and the ugly

Cited by 3 publications

References 17 publications

Pure White Cell Aplasia and Immune Thrombocytopenia after Thymoma Resection: A Case Report and Review of the Literature

Pure White Cell Aplasia and Immune Thrombocytopenia after Thymoma Resection: A Case Report and Review of the Literature

Thymoma With Triple Threat: Pure Red Cell Aplasia, Autoimmune Hemolytic Anemia, and T-Cell Large Granular Lymphocytic Leukemia

A case of resection of type B1 thymoma with neutropenia

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