Montserrat I, Sardà P, López R, Illa I, Bordes R, Ayats R
Departamento de Hematología, Hospital de la Santa Creu i Sant Pau de Barcelona.
Sangre (Barc). 1996 Jun;41(3):249-52.
A new case of thymoma, myasthenia gravis and pure red cell aplasia is presented. Pure red cell aplasia came out 10 years after the diagnosis of the two other diseases in one of several relapses of metastatic thymoma with clinical signs of myasthenia. Surgery, chemotherapy and radiotherapy besides pyridostigmine treatment were used in the clinical course of the patient. A phenotypical change of medullary T lymphocytes (CD4 to CD8) was observed at the same time of pure red cell aplasia diagnosis. A dual role of medullary CD2+ T cell lymphocytes, stimulant and suppressive, over erythroid progenitor cells (BFU-E and CFU-E) was suggested by in vitro cultures.
本文报告了一例胸腺瘤、重症肌无力和纯红细胞再生障碍性贫血的新病例。在转移性胸腺瘤多次复发且伴有重症肌无力临床症状的其中一次复发中,纯红细胞再生障碍性贫血在另外两种疾病诊断10年后出现。患者的临床治疗过程中采用了手术、化疗、放疗以及吡啶斯的明治疗。在诊断纯红细胞再生障碍性贫血的同时,观察到髓质T淋巴细胞发生了表型变化(从CD4变为CD8)。体外培养提示髓质CD2⁺ T淋巴细胞对红系祖细胞(爆式红系集落形成单位和红系集落形成单位)具有刺激和抑制双重作用。