Myasthenia Gravis with Thymoma and Pure Red Blood Cell Aplasia

Abstract

A case of myasthenia gravis with histopathologic confirmation of spindle cell thymoma and pure red blood cell aplasia is reported. This is the twelfth case in the literature in which a simultaneous occurrence of all three disorders, with documented thymic pathology, is noted. Immunologic observations in this patient include an elevated acetylcholine receptor antibody and antinuclear antibody titer, agglutination of mouse red blood cells when combined with the patient's serum, and lack of inhibition of binding of radioactive erythropoietin to mouse red cell receptors when combined with the patient's serum. Although both myasthenia with thymoma and pure red blood cell aplasia may have a common immunologic denominator, our findings in this case indicate that inhibition of erythropoiesis is unrelated to erythropoietin receptor blockade. An alternative hypothesis is offered based on defective T-cell function.

Myasthenia gravis with thymus hyperplasia and pure red cell aplasia

“…On the other hand, PRCA associated with thymoma is rarely seen [7], and cases of PRCA with thymus hyperplasia are extremely rare [8]. The clinical triad of MG, thymoma and PRCA is well recognized [5]. Until this case, however, a case with PRCA and MG without a thymoma has never been reported.…”

“…It is well known that PRCA is associated with thymoma [4]. In 1954, the first published cases of MG with thymoma and PRCA appeared in the literature [5]. We report the first case of PRCA with MG but without thymoma.…”

Effect of tacrolimus in a patient with pure red-cell aplasia

“…Association of MG with thymoma and PRCA has been documented. Defective T‐cell function may be the common causation in both MG and PRCA (Bailey et al. , 1988).…”

“…Association of MG with thymoma and PRCA has been documented. Defective T-cell function may be the common causation in both MG and PRCA (Bailey et al, 1988). Current treatment of acquired PRCA includes several immunosuppressive agents, such as corticosteroids and cyclosporin A (CyA) (Erslev & Soltan, 1996).…”

Spontaneous Resolution of Severe Aplastic Anemia following Thymic Hemorrhage

“…Various neoplastic and non-neoplastic lesions of the thymus are associated with an autoimmune phenomenon, of which myasthenia gravis and pure red cell aplasia are relatively common, though severe AA has also been reported [4]. However, thymectomy has not been used as a modality of treatment for severe AA.…”