Department of Thoracic, Endocrine Surgery and Oncology, Institute of Health Bioscience, University of Tokushima Graduate School, kuramoto-cho 3-18-15, Tokushima, 770-8503, Japan.
Surg Today. 2013 Jul;43(7):806-8. doi: 10.1007/s00595-012-0272-z. Epub 2012 Aug 2.
A 53-year-old female with pemphigus vulgaris received treatment with prednisolone for 3 years. On chest computed tomography performed at follow-up, an anterior-mediastinal tumor (4 cm × 3 cm) was detected and diagnosed as a thymoma. Although amyosthenia was absent, the patient's anti-acetylcholine-receptor antibody level was high, and she was positive for anti-desmoglein 3 antibodies. She underwent extended thymectomy in the same year, following which both the anti-acetylcholine receptor antibody and the anti-desmoglein 3 antibody levels were normalized. The patient's skin symptoms improved, and the steroid dose was gradually lowered and finally discontinued 4 years postoperatively. Extended thymectomy may be an effective therapy for treating patients with pemphigus.
一位 53 岁女性患有寻常型天疱疮,接受了 3 年的泼尼松龙治疗。在随访时进行的胸部计算机断层扫描发现前纵隔肿瘤(4×3cm),诊断为胸腺瘤。尽管没有肌无力,但患者的乙酰胆碱受体抗体水平很高,并且抗桥粒芯糖蛋白 3 抗体阳性。同年,她接受了扩大胸腺切除术,此后乙酰胆碱受体抗体和桥粒芯糖蛋白 3 抗体水平均恢复正常。患者的皮肤症状改善,皮质类固醇剂量逐渐降低,术后 4 年最终停用。扩大胸腺切除术可能是治疗天疱疮患者的有效方法。