非重症肌无力免疫综合征与胸腺：胸腺切除术有作用吗？

Non-Myasthenia Gravis Immune Syndromes and the Thymus: Is There a Role for Thymectomy?

作者信息

Wightman Sean C, Shrager Joseph B

机构信息

Division of Thoracic Surgery, Department of Cardiothoracic Surgery, Stanford University Hospitals and Clinics, 300 Pasteur Drive, Stanford, CA 94305, USA.

出版信息

Thorac Surg Clin. 2019 May;29(2):215-225. doi: 10.1016/j.thorsurg.2018.12.008. Epub 2019 Mar 7.

DOI:10.1016/j.thorsurg.2018.12.008

PMID:30928003

Abstract

Thymectomy has long been considered, performed, and discussed for many different nonmyasthenic immune syndromes. Thymectomy is now an established treatment for MG, and has been performed for other immune syndromes with varying degrees of improvement. Although numerous reports document immune syndromes' association with thymoma, few address the role of thymectomy in symptom resolution. This review assesses thymectomy in the various nonmyasthenic immune syndromes for which it has been tried. Based on this review, it seems appropriate to revisit a more active role for thymectomy in pure red cell aplasia, pemphigus, rheumatoid arthritis, autoimmune hemolytic anemia, and ulcerative colitis.

摘要

长期以来，胸腺切除术一直被用于多种不同的非重症肌无力免疫综合征，并得到了实施和讨论。胸腺切除术现已成为治疗重症肌无力的既定疗法，并且已用于其他免疫综合征，取得了不同程度的改善。尽管有大量报告记录了免疫综合征与胸腺瘤的关联，但很少有报告探讨胸腺切除术在症状缓解中的作用。本综述评估了已尝试使用胸腺切除术治疗的各种非重症肌无力免疫综合征。基于本综述，似乎有必要重新审视胸腺切除术在纯红细胞再生障碍性贫血、天疱疮、类风湿性关节炎、自身免疫性溶血性贫血和溃疡性结肠炎中发挥更积极作用的可能性。