Department of Internal Medicine, Division of Rheumatology, Keio University School of Medicine, Tokyo, Japan.
Department of Internal Medicine, Division of Allergy and Rheumatology, Iwate Medical University School of Medicine, Morioka, Japan.
Immunol Med. 2023 Mar;46(1):25-31. doi: 10.1080/25785826.2022.2129371. Epub 2022 Oct 6.
We investigated the presence of radiographic thymus variants using a scoring system and examined their association with clinical and immunological features in primary Sjögren's syndrome (pSS) and polymyositis/dermatomyositis (PM/DM) patients. Cases of 72 patients with pSS and 47 with PM/DM were randomly selected from all visitors to our department who received chest CT scanning, excluding those with thymoma or thymic cyst, or age <30 years. We quantitatively interpreted and assessed thymus size and attenuation score in axial CT images. Thymic enlargement was identified in 16 (22.2%) pSS and 14 (29.8%) PM/DM patients. A thymus attenuation score ≥ 2 was seen in 11 (15.3%) pSS and 9 (19.1%) PM/DM patients. Thymic enlargement showed a significant association with the titre of rheumatoid factor in PM/DM patients. Thymic enlargement and score showed a significant association with body weight in pSS patients. Radiographic thymus variants are often observed in pSS and PM/DM patients, particularly in cases of PM/DM, and may suggest the role of an abnormal immune response in their pathogenesis.
我们使用评分系统研究了影像学胸腺变异的存在，并检查了它们与原发性干燥综合征 (pSS) 和多发性肌炎/皮肌炎 (PM/DM) 患者的临床和免疫学特征之间的关联。从我院接受胸部 CT 扫描的所有就诊者中随机选择了 72 例 pSS 病例和 47 例 PM/DM 病例，排除胸腺瘤或胸腺囊肿患者，或年龄<30 岁的患者。我们在轴向 CT 图像中对胸腺大小和衰减评分进行了定量解释和评估。16 例 (22.2%) pSS 和 14 例 (29.8%) PM/DM 患者存在胸腺肿大。11 例 (15.3%) pSS 和 9 例 (19.1%) PM/DM 患者的胸腺衰减评分≥2。PM/DM 患者的胸腺肿大与类风湿因子滴度显著相关。在 pSS 患者中，胸腺肿大和评分与体重显著相关。影像学胸腺变异在 pSS 和 PM/DM 患者中经常观察到，尤其是在 PM/DM 患者中，这可能提示异常免疫反应在其发病机制中的作用。
