C Bernard1, H Frih2, F Pasquet3, S Kerever4, Y Jamilloux2, F Tronc5, B Guibert6, S Isaac7, M Devouassoux8, L Chalabreysse9, C Broussolle2, P Petiot10, N Girard11, P Sève2. 1. Department of Internal Medicine, Croix-Rousse Hospital, Hospices Civils de Lyon, Claude Bernard University Lyon 1, Lyon, France. Electronic address: claire.bernard32@gmail.com. 2. Department of Internal Medicine, Croix-Rousse Hospital, Hospices Civils de Lyon, Claude Bernard University Lyon 1, Lyon, France. 3. Department of Internal Medicine - Oncology, Desgenettes Instruction Hospital of Army, 108Bd Pinel Lyon 69003, Lyon, France. 4. Department of Anaesthesiology and Critical Care, Lariboisière University Hospital, AP-HP, Paris, France; ECSTRA Team, CRESS, Epidemiology and Statistics Center, Sorbonne Paris Cité, UMR 1153, INSERM, Paris, France; University Denis Diderot - Paris VII, Paris, France. 5. Department of Thoracic and Cardio-vascular surgery, Louis Pradel Hospital, Hospices Civils de Lyon, Bron, France. 6. Department of Thoracic and Cardio-vascular surgery, Lyon Sud Hospital, Hospices Civils de Lyon, Pierre-Bénite, France. 7. Department of Pathology, Lyon Sud Hospital, Hospices Civils de Lyon, Pierre-Bénite, France. 8. Department of Pathology, Croix-Rousse Hospital, Hospices Civils de Lyon, Claude Bernard University Lyon 1, Lyon, France. 9. Department of Pathology, Louis Pradel Hospital, Hospices Civils de Lyon, Bron, France. 10. Department of Neurology, Croix-Rousse Hospital, Hospices Civils de Lyon, Claude Bernard University Lyon 1, Lyon, France. 11. Department of Respiratory Medicine, Louis Pradel Hospital, Hospices Civils de Lyon, Bron, France.
Abstract
OBJECTIVES: To describe the clinical features, treatment, and outcome of autoimmune diseases (AD) in a cohort of patients with thymoma. DESIGN: Pathological records from three university hospitals, between 2005 and 2011, were reviewed to identify patients with thymoma. Patients with thymoma and AD were compared with patients with thymoma without AD. RESULTS: 47/85 (55%) cases of thymoma had AD, including myasthenia gravis (MG) (n=33), Hashimoto's thyroiditis (n=4), Isaac's syndrome (n=3), Morvan syndrome (n=2), pure red cell aplasia (n=2), systemic lupus (n=2), lichen planus (n=2), and one case of each following conditions: aplastic anemia, autoimmune hemolytic anemia, Good's syndrome, pemphigus, autoimmune hepatitis, Graves' disease, limbic encephalitis, and inflammatory myopathy. Six patients (7%) presented at least 2 ADs. The median duration of follow-up after surgery was 60 months (40-78 months). In 32 patients, the diagnosis of AD preceded the diagnosis of thymoma, in 9 patients, thymoma was diagnosed at the same time as the AD and 7 patients had been operated on when they developed an AD. We found a significative difference on the Masaoka stage between the MG patients and the patients who present another AD (p=0.028). No risk factor for developing an AD after thymectomy was identified. CONCLUSIONS: We describe here the long-term follow-up of a large series of AD related to thymoma. Our results confirm previous data concerning AD occurrence in patients with thymoma and suggest that preexisting autoimmunity is not a risk factor for developing autoimmune manifestations after thymectomy.
OBJECTIVES: To describe the clinical features, treatment, and outcome of autoimmune diseases (AD) in a cohort of patients with thymoma. DESIGN: Pathological records from three university hospitals, between 2005 and 2011, were reviewed to identify patients with thymoma. Patients with thymoma and AD were compared with patients with thymoma without AD. RESULTS: 47/85 (55%) cases of thymoma had AD, including myasthenia gravis (MG) (n=33), Hashimoto's thyroiditis (n=4), Isaac's syndrome (n=3), Morvan syndrome (n=2), pure red cell aplasia (n=2), systemic lupus (n=2), lichen planus (n=2), and one case of each following conditions: aplastic anemia, autoimmune hemolytic anemia, Good's syndrome, pemphigus, autoimmune hepatitis, Graves' disease, limbic encephalitis, and inflammatory myopathy. Six patients (7%) presented at least 2 ADs. The median duration of follow-up after surgery was 60 months (40-78 months). In 32 patients, the diagnosis of AD preceded the diagnosis of thymoma, in 9 patients, thymoma was diagnosed at the same time as the AD and 7 patients had been operated on when they developed an AD. We found a significative difference on the Masaoka stage between the MGpatients and the patients who present another AD (p=0.028). No risk factor for developing an AD after thymectomy was identified. CONCLUSIONS: We describe here the long-term follow-up of a large series of AD related to thymoma. Our results confirm previous data concerning AD occurrence in patients with thymoma and suggest that preexisting autoimmunity is not a risk factor for developing autoimmune manifestations after thymectomy.
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