Benefit of Thymectomy in Immune Diseases Other Than Myasthenia

Szobor, A

doi:10.1016/s0140-6736(84)90147-8

Cited by 10 publications

(4 citation statements)

References 3 publications

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“…In recent years, there has been growing evidence of systemic autoimmune diseases (AIDs) occurring many years after Tx in patients with MG or other immune‐mediated diseases 10‐18 . The data reveled the long‐term effect of Tx on T cell and on T cell–dependent B‐cell activity in MG appear to be controversial.…”

Section: Introductionmentioning

confidence: 99%

“…8 In recent years, there has been growing evidence of systemic autoimmune diseases (AIDs) occurring many years after Tx in patients with MG or other immune-mediated diseases. [10][11][12][13][14][15][16][17][18] The data reveled the long-term effect of Tx on T cell and on T cell-dependent B-cell activity in MG appear to be controversial. Our aim was to evaluate the role of Tx to clarify whether it may be regarded as therapeutic or a factor paving the way to the onset of ADs.…”

Section: Introductionmentioning

confidence: 99%

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Risk of incident autoimmune diseases in patients with thymectomy

Lin

Chang

Hou

et al. 2020

Ann Clin Transl Neurol

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Objectives: 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. Methods: 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. Results: 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). Interpretation: 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.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Risk of incident autoimmune diseases in patients with thymectomy

Lin

Chang

Hou

et al. 2020

Ann Clin Transl Neurol

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“…Histologically, follicular hyperplasia and signs of involution or atrophy of thè thymus have been found while study of thè thymic lymphocyte responso to stimulation with various mitogens or with specific antibodies has shown a significant decrease in thè responso to stimulation with antithymocytic globulin (AGT) or with concanavalin A [52,53]. The hypothesis that thè thymus plays a fundamental part in thè onset or anyway in thè course of MS receives further support from thè clinical improvement observed in MS patients after thymectomy [54]. Ferguson et al [55,56] reported a fair improvement in thè clinical signs and symptoms of ali groups classified by functional status on thè Kurtzke scale [57] and of pyramidal functions in MS patients subjected to thymectomy combined with azathioprine therapy, in thè first year after operation.…”

Section: The Thymus In Msmentioning

confidence: 99%

The role of the thymus in multiple sclerosis

D’Andrea

Meco

F³

et al. 1989

Ital J Neuro Sci

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The presence of numerous changes in T lymphocyte activity found in MS patients points to the involvement of the thymus in multiple sclerosis. The etiophathogenetic mechanism of MS is probably an autoimmune reaction that is triggered by a viral infection caused by one or more viruses and that perpetuates itself, causing the disease to progress. It has been proved that the thymus maintains its immunocompetence even in adulthood and that it has a role in the pathogenesis in several autoimmune diseases. In exacerbations of MS there is a decrease in T suppressor lymphocytes while histological and lymphocyte subset changes have been demonstrated in the thymus of MS patients. The lymphocyte response to mitogens is also depressed in MS. The clinical results of thymectomy in MS are not uniform and are on the whole inconclusive, probably through the lack of criteria of selection of patients for surgical treatment. We consider that the morphological and functional study of the thymus biopsy specimen should supply the appropriate criteria of suitability for surgical treatment.

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“…The authors of a review of 598 patients with thymoma reported that 71% of those patients had several types of immune-mediated disorders, and the most prevalent disorders were myasthenia gravis followed by pure red cell aplasia, polymyositis, and systemic lupus erythematosus [1]. A high frequency of autoimmune diseases in patients with thymic tumor and the efficacy of thymectomy for achieving the remission of autoimmune diseases were also reported [2].…”

Section: Introductionmentioning

confidence: 99%

Microscopic polyangiitis associated with thymic tumor: a case report and review of the literature

et al. 2019

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Background Thymic hyperplasia and thymic epithelial tumor (thymoma) have been associated with a variety of autoimmune diseases. Renal involvement has been reported in patients with thymoma. Minimal change disease and membranous nephropathy are frequently observed in glomerular lesions of thymoma patients, but ANCA-associated renal vasculitis is rare. We present a case of thymoma-associated microscopic polyangiitis with positivity for three ANCAs: MPO-ANCA, PR3-ANCA and azurocidin-ANCA. Case presentation An 89-year-old Japanese woman was admitted to our hospital following an episode of general fatigue, nausea, muscle weakness of the lower limbs, and ophthalmoplegia. On urinalysis, proteinuria, hematuria, and cellular casts were observed. Elevated levels of serum creatinine and C-reactive protein were also demonstrated, and MPO-, PR3- and azurocidin-ANCA were detected on serological examination. Renal biopsy showed pauci-immune crescentic glomerulonephritis. We therefore diagnosed rapidly progressive glomerulonephritis due to microscopic polyangiitis. Acetylcholine-receptor antibody was also detected. Chest computed tomography and MRI revealed a lobulated tumor in the anterior mediastinum. We thus also diagnosed myasthenia gravis with thymoma. Conclusion Considering the patient’s triple-ANCA positivity, thymic diseases may be associated with the pathogenesis of ANCA-associated vasculitis due to central T-cell tolerance. A further accumulation of cases is needed, because thymectomy does not always induce the remission of thymoma-associated autoimmune diseases. Electronic supplementary material The online version of this article (10.1186/s12882-019-1319-9) contains supplementary material, which is available to authorized users.

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Benefit of Thymectomy in Immune Diseases Other Than Myasthenia

Cited by 10 publications

References 3 publications

Risk of incident autoimmune diseases in patients with thymectomy

Risk of incident autoimmune diseases in patients with thymectomy

The role of the thymus in multiple sclerosis

Microscopic polyangiitis associated with thymic tumor: a case report and review of the literature

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