Department of Neurology, Penang General Hospital, Penang, Malaysia; Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom.
Department of Neurology, Island Hospital, Penang, Malaysia.
J Neuroimmunol. 2018 Apr 15;317:100-102. doi: 10.1016/j.jneuroim.2018.01.011. Epub 2018 Feb 1.
Thymoma is associated with a wide spectrum of autoimmune paraneoplastic syndromes, though it is uncommon for multiple paraneoplastic syndromes to be present in a single individual. We report a rare case of an elderly gentleman who was found to have thymoma-associated myasthenia gravis and LGI1-encephalitis with myokymia, who presented with nephrotic syndrome (minimal change glomerulopathy) after thymectomy. The latter two paraneoplastic syndromes had manifested when prednisolone was tapered down to low dose. This case serves to remind neurologists that apart from paraneoplastic neurological manifestations, thymoma may also be associated with renal disease. Nephropathy in myasthenia patients with thymoma should be properly evaluated, as it is treatable with immunotherapy, and it may even occur post-thymectomy.
胸腺瘤与广泛的自身免疫性副肿瘤综合征相关，尽管在单个个体中同时存在多种副肿瘤综合征并不常见。我们报告了一例罕见病例，一名老年男性被发现患有胸腺瘤相关重症肌无力和 LGI1 脑炎伴肌阵挛，在接受胸腺切除术 后出现肾病综合征（微小病变性肾小球病）。后两种副肿瘤综合征在泼尼松龙逐渐减量至低剂量时表现出来。这个病例提醒神经科医生，除了副肿瘤性神经表现外，胸腺瘤也可能与肾脏疾病相关。胸腺瘤重症肌无力患者的肾病应进行适当评估，因为它可以通过免疫治疗治疗，甚至可能在胸腺切除术后发生。
