Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine, Japan.
Postgraduate Medical Education Center, Keio University Hospital, Japan.
Intern Med. 2023 Jan 15;62(2):243-249. doi: 10.2169/internalmedicine.9743-22. Epub 2022 Jun 14.
The precise manipulation of immune tolerance is the holy grail of immunotherapies for both autoimmunity and cancer immunity. Thymomas are well known to be associated with autoimmune diseases. The exact mechanism by which autoreactivity is induced after thymectomy remains to be elucidated. We herein present the case of a 50-year-old lady with concurrent de novo type 1 autoimmune hepatitis (AIH) and pure red cell aplasia (PRCA), 1 month after undergoing a successful total thymectomy for combined squamous cell carcinoma and thymoma (Masaoka stage II). Corticosteroids yielded short-term effects for both AIH and PRCA. Literature on thymoma-associated AIH, an extremely rare immune-related comorbidity, was also reviewed.
精确地调控免疫耐受是自身免疫和癌症免疫治疗的圣杯。胸腺瘤与自身免疫性疾病密切相关。确切的机制,自身反应性是诱导胸腺瘤切除后仍然需要阐明。我们在此提出一个 50 岁的妇女的情况下,并发 1 型自身免疫性肝炎(AIH)和纯红细胞再生障碍性贫血(PRCA),1 个月后接受成功的总胸腺切除术为联合鳞状细胞癌和胸腺瘤(Masaoka 期 II)。皮质类固醇对 AIH 和 PRCA 均有短期疗效。还对胸腺瘤相关 AIH 的文献进行了回顾,这是一种极其罕见的免疫相关合并症。