Thymoma with Pemphigus Foliaceus.

Takeshita, Kei; Amano, Maki; Shioiri, Takayuki; Oyamada, Yoshitaka; Abiko, Tomohiro; Kobayashi, Koichi; Futei, Yuko; Amagai, Masayuki; Kuramochi, Shigeru; Asano, Koichiro; Yamaguchi, Kazuhiro

doi:10.2169/internalmedicine.39.742

Cited by 19 publications

(13 citation statements)

References 16 publications

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“…There are in total 11 case reports of PF complicated with the tumors during the period 1998–2004 in Japan. We studied how the eruptions of PF in these cases had changed before and after the tumor treatments in these cases 5–13 . In two out of the 11 cases, PF occurred after the tumor resections.…”

Section: Discussionmentioning

confidence: 99%

Case of pemphigus foliaceus that shifted into pemphigus vulgaris after adrenal tumor resection

Awazawa

Yamamoto

Gushi

et al. 2007

The Journal of Dermatology

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A 79-year-old Japanese woman visited our hospital on 6 May 2003, who had suffered from erythema and crusted vesicles located on the head, face and trunk. The eruptions first appeared in February 2003. Histopathological findings included blister formation spreading from just below the horny layers to the upper squamous layers, where acantholytic cells were observed. Direct immunofluorescence disclosed immunoglobulin G depositions in the epidermal intercellular spaces. Enzyme-linked immunosorbent assay showed an elevated titer of anti-desmoglein (Dsg)1 autoantibodies (154 index value), but almost normal levels of anti-Dsg3 autoantibodies (8 index value in serum). The diagnosis at first was made as pemphigus foliaceus (PF). Topical use of corticosteroids alone could control the eruptions well. Systemic examinations on admission revealed a right adrenal tumor that had caused Cushing's syndrome. Its resection was performed on 24 July 2003. Histopathological diagnosis of the removed tumor was a functional adrenal adenoma. The symptoms had worsened after the resection. Topical use of corticosteroids alone could no longer control the symptoms. Additional p.o. medications of minocycline hydrochloride and nicotinic acid amides improved the symptoms to some extent. However, oral cavity erosions appeared in December 2004, and the titer of anti-Dsg3 autoantibodies in serum elevated, suggesting a transition from PF to pemphigus vulgaris (PV). p.o. administration of corticosteroids started, which improved the symptoms significantly. To date, there have been no reports of pemphigus complicated with an adrenal tumor that caused Cushing's syndrome in Japan. The present case is particularly interesting in that the symptoms became worse after the tumor resection and that the first diagnosis of PF shifted into PV after the operation.

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Section: Discussionmentioning

confidence: 99%

Case of pemphigus foliaceus that shifted into pemphigus vulgaris after adrenal tumor resection

Awazawa

Yamamoto

Gushi

et al. 2007

The Journal of Dermatology

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“…Management for both PF and MG includes immunosuppression with prednisolone and steroid‐sparing agents . In previous reports, MG has developed prior to pemphigus and it has been postulated that the thymus has a role as a possible site of origin due to cross‐reactivity of myoid cells and Hassall's corpuscles within the thymus, which are structurally similar to muscle and epidermis . Cortisol‐producing adrenal adenomas are sometimes diagnosed following systemic manifestations of Cushing syndrome due to excess production of endogenous steroids, or when functional testing shows subclinical Cushing syndrome after being initially identified as an adrenal incidentaloma …”

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confidence: 99%

A patient with pemphigus foliaceus and myasthenia gravis treated by a cortisol-secreting adrenal adenoma

et al. 2014

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“…While MG is frequently associated with thymoma, PPP has only rarely been reported in thymoma patients [7][8][9][10][11]. We now report on a patient with the rare triade of thymoma, MG and PPP and describe for the first time the course of desmoglein antibodies before and after thymectomy.…”

Section: Letter To the Editorsmentioning

confidence: 94%