Article

Triad of thymoma, myasthenia gravis and pure red cell aplasia combined with Sjögren’s syndrome

Fukushima Medical University Department of Pathology Fukushima Japan
The Japanese Journal of Thoracic and Cardiovascular Surgery 04/2012; 52(7):345-348. DOI:10.1007/s11748-004-0068-1 pp.345-348

ABSTRACT A 36-year-old woman complained of cough and high fever. Computed tomographic scans demonstrated a mediastinal mass. A couple
of months later, she developed dryness in her eyes and mouth. Biopsy of the lip confirmed the diagnosis of Sjögren’s syndrome.
She underwent thymo-thymomectomy. Pathological findings of the mass revealed thymoma. At two months after surgery, she developed
ptosis and dysphagia that were compatible with myasthenia gravis. The clinical symptoms were adequately controlled with prednisolone.
At eleven months after surgery, she presented with severe anemia, which led to the diagnosis of pure red cell aplasia. The
following treatment with cyclosporin caused hemoglobin concentration to rise. However, she continues to suffer from dryness
of her eyes and mouth. The case is the first to be reported with Sjögren’s syndrome and the triad of thymoma, myasthenia gravis
and pure red cell aplasia, and is compared with previously reported cases of the three conditions.

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Keywords

36-year-old woman
 
Biopsy
 
cases
 
clinical symptoms
 
Computed tomographic scans
 
dysphagia
 
eyes
 
hemoglobin concentration
 
mediastinal mass
 
myasthenia gravis
 
Pathological findings
 
prednisolone
 
pure red cell aplasia
 
severe anemia
 
Sjögren’s syndrome
 
thymoma
 

Koichi Fujiu