Thymomes et maladies auto-immunes

A tale of autoimmunity: thymoma, thymectomy, and systemic lupus erythematosus

“…In our case, the patient had a WHO class AB and Masaoka stage I thymoma associated with PRCA and late post-thymectomy development of SLE. PRCA has been reported in about 10% of thymoma cases, and thymectomy has been considered as the treatment of choice in these cases; however, only 25-30% of cases respond to this treatment [1][2][3]18]. In this case, our patient's PRCA initially improved with chemotherapy, however subsequently failed to respond to thymectomy, and ultimately was complicated by post-thymectomy SLE, which, in turn, was further complicated by progressive pancytopenia.…”

“…Thymic epithelial tumors are comprised of two different tumor types including thymomas and thymic carcinomas [9,18]. While thymomas are rare, they remain the most common mediastinal mass in adults, comprising up to 25% of mediastinal masses [2].…”

“…Compared to thymic carcinomas, thymomas are more frequently associated with autoimmune disease and paraneoplastic syndromes including but not limited to myasthenia gravis, PRCA, SLE, bullous pemphigoid, polymyositis, and syndrome of inappropriate anti-diuretic hormone [1,2,13,18]. While it is well-recognized that these diseases may occur in the absence of a thymoma, the presence of a thymoma has been associated with a worse prognosis, which in some part, appears to be dependent on thymoma WHO classification and Masaoka staging [1-3, 9, 10].…”

“…Bernard et al concluded that no clinical nor pathological features predicted the development of autoimmune disorders post-thymectomy and that preexisting autoimmunity was not identified as a risk factor for autoimmunity post-thymectomy [1]. Several cases of thymomaassociated PRCA and/or SLE, as well as their incidence post-thymectomy, have been reported in the medical literature [15][16][17][18][19][20][21][22][23][24]. In our case, the patient had a WHO class AB and Masaoka stage I thymoma associated with PRCA and late post-thymectomy development of SLE.…”

Thymoma, thymectomy, and occurrence of systemic lupus erythematosus: a commentary article

“…I read the interesting manuscript entitled "Thymoma and autoimmune diseases" recently written by Jamilloux et al In their paper, they stated that no characteristics or pathological information can predict the occurrence of an autoimmune disease after a thymectomy [1]. However, I think this opinion may not be extended to all autoimmune diseases.…”