Myasthenia Gravis Associated with Thymoma and Aplastic Anemia: Case Report

Grbelja, Lidija Dežmalj; Vrhovać, Radovan; Ulamec, Monika

doi:10.20471/acc.2017.56.04.34

Cited by 2 publications

(1 citation statement)

References 8 publications

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“…The co-existence of myasthenia gravis and paroxysmal nocturnal hemoglobinuria is rare. Three cases have been published so far [ 11 , 12 , 13 ]. The common pathophysiology mechanism involving the complement system provides a unique opportunity to target both diseases with one drug.…”

Section: Introductionmentioning

confidence: 99%

Eculizumab Treatment of Massive Hemolysis Occurring in a Rare Co-Existence of Paroxysmal Nocturnal Hemoglobinuria and Myasthenia Gravis

Bicskó,

Illés,

Hevessy

et al. 2024

Hematology Reports

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The co-occurrence of myasthenia gravis (MG) and paroxysmal nocturnal hemoglobinuria (PNH) is rare; only one case has been published so far. We report a 63-year-old Caucasian female patient who was diagnosed with MG at the age of 43. Thymoma was also detected, and so it was surgically resected, which resulted in reasonable disease control for nearly 20 years. Slight hemolysis began to emerge, and then myasthenia symptoms progressed, so immunosuppressive therapy was started. Due to progressive disease and respiratory failure, the patient underwent plasmapheresis, and ventilatory support was stopped. Marked hemolysis was present, and diagnostic tests confirmed PNH with type III PNH cells. Her myasthenia symptoms aggravated, mechanical ventilation had to be started again, and due to the respiratory acidosis, massive hemolysis occurred. After two plasmapheresis sessions, the patient received eculizumab at 600 mg, resulting in prompt hemolysis control. After the second dose of the treatment, the patient was extubated. Still, due to their inability to cough, she developed another respiratory failure and pneumonia–sepsis, resulting in the patient’s death. This case highlights the rare association between these two serious diseases and similar immune-mediated pathophysiology mechanisms involving the complement system.

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Section: Introductionmentioning

confidence: 99%

Eculizumab Treatment of Massive Hemolysis Occurring in a Rare Co-Existence of Paroxysmal Nocturnal Hemoglobinuria and Myasthenia Gravis

Bicskó,

Illés,

Hevessy

et al. 2024

Hematology Reports

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Severe Aplastic Anemia Developed after Thymectomy: A Case Report and Literature Review

Rodrigues

Freire

Campos

et al. 2020

Case Reports in Hematology

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Thymus neoplasms are frequently related to paraneoplastic autoimmune manifestations. Its most common associations are myasthenia gravis and pure red cell aplasia. Aplastic anemia has been increasingly documented as an initial presentation of thymoma. Nevertheless, its development after successful surgical resection of thymoma is a rare condition. We report a case of a 53-year-old man with severe aplastic anemia preceded by amegakaryocytic thrombocytopenia three years after thymectomy with no signs of disease recurrence. He underwent immunosuppressive therapy with cyclosporine 5 mg/kg/day and prednisone 2 mg/kg/day for six weeks. Considering the availability of a compatible donor, allogeneic stem cell transplantation was carried out. However, the patient died 11 days after transplant. A literature review was conducted, and another ten cases of aplastic anemia, diagnosed three months to four years after thymectomy, were identified. These cases suggest persistence of peripheral self-reactive T lymphocytes even years after tumor definitive treatment.

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Myasthenia Gravis Associated with Thymoma and Aplastic Anemia: Case Report

Cited by 2 publications

References 8 publications

Eculizumab Treatment of Massive Hemolysis Occurring in a Rare Co-Existence of Paroxysmal Nocturnal Hemoglobinuria and Myasthenia Gravis

Eculizumab Treatment of Massive Hemolysis Occurring in a Rare Co-Existence of Paroxysmal Nocturnal Hemoglobinuria and Myasthenia Gravis

Severe Aplastic Anemia Developed after Thymectomy: A Case Report and Literature Review

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