Gonlugur U, Sahin E, Yildiz E, Gonlugur Tanseli E
Department of Chest Diseases, Cumhuriyet University Medical School, 58140, Sivas, Turkey.
Acta Microbiol Immunol Hung. 2006 Mar;53(1):105-11. doi: 10.1556/AMicr.53.2006.1.8.
Thymoma has been associated with a variety of autoimmune disorders. We report a case of myasthenia gravis and pancytopenia in a 53-year-old man with lymphoepithelial thymoma and interstitial lung disease. Preoperative examination revealed neither hematologic abnormality nor myasthenia gravis. The patient had enteritis prior to thymomectomy, sternal infection in the first month of operation, and urinary infection at the third month. About three months after thymomectomy, he required mechanical ventilation support due to myasthenia gravis-related respiratory failure. One month later, a rapidly progressing pancytopenia developed. The patient died within two weeks of overwhelming septicemia unresponsive to treatment with antibiotics and steroids. The possible onset of myasthenia gravis or pancytopenia after thymomectomy should be kept in mind during follow-up. Recurrent infections in the early stages of thymomectomy may suggest a lethal onset of pancytopenia.
胸腺瘤与多种自身免疫性疾病有关。我们报告一例53岁男性，患有淋巴上皮性胸腺瘤和间质性肺病，出现重症肌无力和全血细胞减少。术前检查未发现血液学异常及重症肌无力。该患者在胸腺切除术前患有肠炎，术后第一个月发生胸骨感染，第三个月发生尿路感染。胸腺切除术后约三个月，他因重症肌无力相关的呼吸衰竭需要机械通气支持。一个月后，迅速进展的全血细胞减少症出现。患者在对抗生素和类固醇治疗无反应的严重败血症发作两周内死亡。在随访过程中应牢记胸腺切除术后可能发生重症肌无力或全血细胞减少。胸腺切除术后早期反复感染可能提示全血细胞减少症的致命发作。
