Division of Allergy, Immunology and Rheumatology, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
Division of Rheumatology, Immunology and Allergy, Department of Internal Medicine, Taipei Medical University Hospital, Taipei, Taiwan.
Ann Clin Transl Neurol. 2020 Jul;7(7):1072-1082. doi: 10.1002/acn3.51055. Epub 2020 Jun 1.
The data concerning the association between Tx and ADs remain unclear and are scarce. This study was undertaken to investigate whether people with Tx are more likely to develop ADs, compared to those without Tx.
Individuals who received Tx between 2002 and 2015 were identified and matched on age and sex with individuals without Tx. We performed multivariate and stratified analysis using the Kaplan-Meier method and Cox proportional hazards models in order to estimate the association between Tx and the risk of developing ADs.
A total of 2550 thymectomized (Txd) patients and 24,664.941 non-Txd comparison subjects were selected from NHIRD. Tx-MG (myasthenia gravis) as compared with general population (nonTx-nonMG), adjusted hazard ratio (aHR) were higher for incident Addison disease (aHR = 10.40, 95% CI 1.01-107), autoimmune hemolytic anemia (aHR = 21.54, 95% CI 2.06-14.8), Hashmoto thyroiditis (aHR = 5.52, 95% CI 1.34-34.7), ankylosing spondylitis (aHR = 2.73, 95% CI 1.09-6.84), rheumatoid arthritis (aHR = 5.25, 95% CI 1.79-15.47), primary Sjogren syndrome (pSS) (aHR = 3.77, 95% CI 1.30-11.0), and systemic lupus erythemtoasus (aHR = 10.40). Tx-nonMG as compared with general population, aHR were higher for incident autoimmune hemolytic anemia (aHR = 25.50), Hashmoto thyroiditis (aHR = 6.75) and systemic lupus erythematosus (SLE) (aHR = 13.38). NonTx-MG as compared with general population, aHR were higher for incident Hashmoto thyroiditis (aHR = 6.57), pSS (aHR = 4.50), SLE (aHR = 17.29), and systemic vasculitis (aHR = 25.86).
In conclusion, based on a retrospective cohort study throughout Taiwan, patients with Tx have a higher risk of new onset ADs than patients without Tx.
Tx 与自身免疫性疾病（ADs）之间的关联数据仍不清楚且有限。本研究旨在调查 Tx 患者与无 Tx 患者相比，是否更容易患上 ADs。
从 NHIRD 中筛选出 2002 年至 2015 年间接受 Tx 的个体，并按年龄和性别与无 Tx 个体进行匹配。我们采用 Kaplan-Meier 法和 Cox 比例风险模型进行多变量和分层分析，以评估 Tx 与 ADs 发病风险之间的关系。
从 NHIRD 中选择了 2550 例胸腺切除术（Txd）患者和 24664.941 名非 Txd 对照组。与一般人群（非 Tx-nonMG）相比，Tx-MG（重症肌无力）的新发 Addison 病（aHR=10.40，95%CI 1.01-107）、自身免疫性溶血性贫血（aHR=21.54，95%CI 2.06-14.8）、桥本甲状腺炎（aHR=5.52，95%CI 1.34-34.7）、强直性脊柱炎（aHR=2.73，95%CI 1.09-6.84）、类风湿关节炎（aHR=5.25，95%CI 1.79-15.47）、原发性干燥综合征（pSS）（aHR=3.77，95%CI 1.30-11.0）和系统性红斑狼疮（SLE）（aHR=10.40）的调整后危险比（aHR）更高。与一般人群相比，Tx-nonMG 的新发自身免疫性溶血性贫血（aHR=25.50）、桥本甲状腺炎（aHR=6.75）和系统性红斑狼疮（SLE）（aHR=13.38）的 aHR 更高。与一般人群相比，非 Tx-MG 的新发桥本甲状腺炎（aHR=6.57）、pSS（aHR=4.50）、SLE（aHR=17.29）和系统性血管炎（aHR=25.86）的 aHR 更高。
总之，基于台湾的一项回顾性队列研究，与无 Tx 患者相比，Tx 患者新发 ADs 的风险更高。
