Aplastic anemia as a late complication of thymoma in remission

Thymoma has many auto-immune associations, including aplastic anemia and myasthenia gravis. The pathophysiologic relationship between thymoma and its auto-immune sequelae are yet to be fully elucidated, but are thought to be as a result of the production of auto-reactive T cell clones by the thymic epithelium. We report a case in which aplastic anemia did not develop until sometime after remission from thymoma had been induced. This observation suggests that auto-reactive T cells may be produced by the thymoma but not induce clinical auto-immune disease until a later time, even after eradication of thymoma has been achieved.