An unusual presentation of thymoma: dysgeusia, ulcerative colitis, keratoconjunctivitis sicca, autoimmune retinopathy and myasthenia gravis

Abstract

A 41-year-old female presented with dysgeusia, dry eyes, nyctalopia with progressive visual field constriction (due to autoimmune retinopathy) and gastrointestinal symptoms (due to ulcerative colitis). She was subsequently admitted to intensive care with a myasthenic crisis, and CT of the thorax demonstrated a thymoma.Following thymectomy and adjuvant radiotherapy, she has remained in complete remission from her ulcerative colitis and myasthenia gravis, her retinopathy has stabilised and there has been no thymoma recurrence over a 10-year postoperative period. There was a brief relapse of her dysgeusia (causing weight loss) and dry eye symptoms 3 years after her surgery, which resolved 8 months later. While the association of thymomas with paraneoplastic syndromes (PNS) is well established, it is unusual to present with multiple PNS, and some of these have only been documented in sparse case reports to date. Thymectomy played a crucial role in improvement and stabilisation of her PNS.

Increased Prevalence of Myasthenia Gravis in a Cohort of Patients with Inflammatory Bowel Disease

“…However, prednisone, azathioprine and in iximab may have also delayed the MG diagnosis in patients 2, 3 and 4, due to partial or even complete control of MG. This pattern was reported elsewhere [22,34,35]. None of our patients underwent thymectomy.…”

Coexistence of neuromyelitis optica AQP4+, myasthenia gravis, and ulcerative colitis: a case report

“…However, it has been shown that they play a role in the onset and duration of the disease, inducing colon inflammation and cytotoxicity 21 . Thymectomy produces good outcomes in the treatment of both disorders 22,23 , as stated by Sanghi and Bremner in the case of a woman with UC, MG, and other symptoms associated with a thymoma 24 .…”