Tajima Yasutaka, Yaguchi Hiroaki, Mito Yasunori
Department of Neurology, Brain Science Centre, Sapporo City General Hospital, Japan.
Intern Med. 2019 May 1;58(9):1341-1347. doi: 10.2169/internalmedicine.1990-18. Epub 2018 Dec 18.
To explore non-motor comorbidities of myasthenia gravis (MG), we present two cases of thymoma-associated MG patients. Alopecia, pure red cell aplasia, and thymoma- associated multiorgan autoimmunity were observed in Case 1, and alopecia, thrombocytopenia, hypogammaglobulinemia and nephrotic syndrome were observed in Case 2. In both cases, autoreactive T lymphocytes inappropriately stimulated by thymus tissue may have played key roles in generating the various autoimmune-associated symptoms. Consequently, systemic immunological involvement due to the thymoma-associated breakdown of immunoregulations in both motor and non-motor systems should be considered in MG patients.
为了探究重症肌无力(MG)的非运动性合并症,我们报告了两例胸腺瘤相关性MG患者的病例。病例1中观察到脱发、纯红细胞再生障碍以及胸腺瘤相关性多器官自身免疫,病例2中观察到脱发、血小板减少、低丙种球蛋白血症和肾病综合征。在这两个病例中,被胸腺组织不适当刺激的自身反应性T淋巴细胞可能在产生各种自身免疫相关症状中起了关键作用。因此,对于MG患者,应考虑到由于胸腺瘤相关的运动和非运动系统免疫调节破坏而导致的全身免疫受累情况。