Jiang Ying, Dai Xiaodan, Duan Liping, Zhou Yaou
Department of Rheumatology and Clinical Immunology, Xiangya Hospital, Central South University, Changsha, Hunan, China.
Adv Clin Exp Med. 2017 Mar-Apr;26(2):237-243. doi: 10.17219/acem/61004.
Autoimmune rheumatic diseases (ARDs), involving immune disturbances resulting from auto-inflammatory mechanisms, are a group of diseases characterized by autoimmunity and autoimmunemediated organ damage. Thymoma, whose mechanism is also associated with immune abnormalities, is the most common neoplasm of the anterior mediastinum. But thymoma with ARDs is relatively less frequent. The clinical characteristics of the coexistence of ARDs and thymomas are still not very clear. And the therapeutic strategy for ARDs combined with thymomas varies, with an uncertain outcome.
The aim of this study was to investigate the clinical characteristics of the coexistence of ARDs and thymomas in order to speculate whether a thymectomy is effective for ARDs combined with thymomas, and to seek the proper therapeutic strategy for treating ARDs combined with thymomas.
We presented 2 cases of the coexistence of ARDs and thymomas. Then, we summarized 20 cases (including our 2 cases) in which the ARD was diagnosed concurrently with, or prior to, the thymoma.
Pure red cell aplastic anemia (PRCA) might be associated with an ARD and a thymoma, and a thymectomy may lead to the appearance, exacerbation, or remission of ARDs.
Searching for a thymoma is necessitated if a patient with ARDs experiences PRCA and the effects of thymectomy in ARDs combined with thymomas may be associated with the onset sequence of ARDs and thymomas.
自身免疫性风湿性疾病(ARDs)涉及由自身炎症机制引起的免疫紊乱,是一组以自身免疫和自身免疫介导的器官损伤为特征的疾病。胸腺瘤是前纵隔最常见的肿瘤,其发病机制也与免疫异常有关。但合并ARDs的胸腺瘤相对较少见。ARDs与胸腺瘤并存的临床特征仍不太清楚。并且ARDs合并胸腺瘤的治疗策略各不相同,预后也不确定。
本研究旨在探讨ARDs与胸腺瘤并存的临床特征,推测胸腺切除术对ARDs合并胸腺瘤是否有效,并寻求治疗ARDs合并胸腺瘤的合适治疗策略。
我们报告了2例ARDs与胸腺瘤并存的病例。然后,我们总结了20例(包括我们的2例)ARDs与胸腺瘤同时诊断或在胸腺瘤之前诊断的病例。
纯红细胞再生障碍性贫血(PRCA)可能与ARDs和胸腺瘤有关,胸腺切除术可能导致ARDs的出现、加重或缓解。
如果ARDs患者出现PRCA,则有必要检查是否存在胸腺瘤,并且胸腺切除术对ARDs合并胸腺瘤的影响可能与ARDs和胸腺瘤的发病顺序有关。