Lu Zhang1, Jie Dong, Xiao-Mei Leng, Xiao-Feng Zeng. 1. Department of Rheumatology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China.
Abstract
OBJECTIVE: To investigate the clinical features and treatment strategy for the thymoma-associated systemic lupus erythematosus (SLE) in a worldwide perspective. METHODS: All articles between 1975 to 2008 were searched with the key words "SLE Thymoma" or "SLE thymectomy" in the database of Pubmed & Medline; the Chinese articles were searched with the same key words in the database of China Hospital Knowledge Database (CHKD). Data were extracted and analyzed. RESULTS: 44 patients from 24 studies were available for this analysis with a male-to-female ratio of 1: 6. The mean age of SLE onset was 47.9 (21-76) while the mean age of discovery of thymoma was 48.5 (18-77). The clinical picture of SLE was classical with no statistical difference between genders. However, the thymoma-associated SLE occurs in patients older than the classical onset age of SLE (P < 0.01). As for treatment, the glucocorticoids-based immune-suppressive therapy still proves to be effective (P < 0.01). The thymoma could be benign or invasive which does not depend on gender or age. There is no statistical difference with regards to pathologic sub-types. As for the patients who already had SLE when discovering the thymoma, the clinical outcomes varied after the thymectomy (remission 27.8%, exacerbation 33.3%, no change 38.9%, P > 0.05). CONCLUSION: The possibility of thymoma should be considered among those late-onset SLE patients. The glucocorticoid-based immunosuppressive therapy is effective for thymoma-associated SLE. To treat SLE is not an indication for thymectomy.
OBJECTIVE: To investigate the clinical features and treatment strategy for the thymoma-associated systemic lupus erythematosus (SLE) in a worldwide perspective. METHODS: All articles between 1975 to 2008 were searched with the key words "SLE Thymoma" or "SLE thymectomy" in the database of Pubmed & Medline; the Chinese articles were searched with the same key words in the database of China Hospital Knowledge Database (CHKD). Data were extracted and analyzed. RESULTS: 44 patients from 24 studies were available for this analysis with a male-to-female ratio of 1: 6. The mean age of SLE onset was 47.9 (21-76) while the mean age of discovery of thymoma was 48.5 (18-77). The clinical picture of SLE was classical with no statistical difference between genders. However, the thymoma-associated SLE occurs in patients older than the classical onset age of SLE (P < 0.01). As for treatment, the glucocorticoids-based immune-suppressive therapy still proves to be effective (P < 0.01). The thymoma could be benign or invasive which does not depend on gender or age. There is no statistical difference with regards to pathologic sub-types. As for the patients who already had SLE when discovering the thymoma, the clinical outcomes varied after the thymectomy (remission 27.8%, exacerbation 33.3%, no change 38.9%, P > 0.05). CONCLUSION: The possibility of thymoma should be considered among those late-onset SLEpatients. The glucocorticoid-based immunosuppressive therapy is effective for thymoma-associated SLE. To treat SLE is not an indication for thymectomy.