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[Thymoma and autoimmune diseases].

Y Jamilloux1, H Frih1, C Bernard1

  • 1Service de médecine interne, hospices civils de Lyon, hôpital de la Croix-Rousse, université Claude-Bernard - Lyon 1, 103, grande rue de la Croix-Rousse, 69004 Lyon, France.

La Revue De Medecine Interne
|April 3, 2017
PubMed
Summary

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Thymoma is linked to various autoimmune diseases, often appearing before or during surgery. Thymectomy

Area of Science:

  • Immunology
  • Oncology
  • Endocrinology

Background:

  • The association between thymoma and autoimmune diseases is well-established.
  • Myasthenia gravis is the most common autoimmune condition associated with thymoma (15-20% of cases).
  • Other reported autoimmune diseases include erythroblastopenia, lupus erythematosus, thyroid disorders, and various cytopenias.

Purpose of the Study:

  • To review the spectrum of autoimmune diseases associated with thymoma.
  • To discuss the timing of autoimmune disease onset relative to thymectomy.
  • To highlight specific clinical scenarios warranting thymoma investigation.

Main Methods:

  • Literature review of autoimmune diseases associated with thymoma.
  • Analysis of the temporal relationship between thymoma and autoimmune conditions.
Keywords:
Autoimmune diseasesGood's syndromeLupus systémiqueMaladies auto-immunesPolymyositePolymyositisSyndrome de GoodSystemic lupusThymomaThymome

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  • Discussion of diagnostic and therapeutic considerations.

    • Main Results:

    • Autoimmune diseases typically manifest before thymectomy but can be diagnosed concurrently or later.
    • Myasthenia gravis and autoimmune erythroblastopenia necessitate systematic thymoma screening.
    • Late-onset lupus or multiple autoimmune conditions also warrant thymoma investigation.
    • Predicting post-thymectomy autoimmune disease occurrence is not possible based on patient or pathological data.
    • Thymectomy's benefit for autoimmune diseases, excluding myasthenia gravis, remains unproven, suggesting a role for peripheral T lymphocytes.

    Conclusions:

    • Thymoma is associated with a wide array of autoimmune disorders beyond myasthenia gravis.
    • Systematic screening for thymoma is crucial in specific autoimmune contexts.
    • Immunoglobulin replacement therapy should be considered for thymoma patients with hypogammaglobulinemia on immunosuppressants due to high infection risk.