Concurrent de novo Thymoma-associated Paraneoplastic Type 1 Autoimmune Hepatitis and Pure Red Cell Aplasia after Thymectomy: A Case Report and Literature Review

Intern Med. 2023 Jan 15;62(2):243-249. doi: 10.2169/internalmedicine.9743-22. Epub 2022 Jun 14.

Abstract

The precise manipulation of immune tolerance is the holy grail of immunotherapies for both autoimmunity and cancer immunity. Thymomas are well known to be associated with autoimmune diseases. The exact mechanism by which autoreactivity is induced after thymectomy remains to be elucidated. We herein present the case of a 50-year-old lady with concurrent de novo type 1 autoimmune hepatitis (AIH) and pure red cell aplasia (PRCA), 1 month after undergoing a successful total thymectomy for combined squamous cell carcinoma and thymoma (Masaoka stage II). Corticosteroids yielded short-term effects for both AIH and PRCA. Literature on thymoma-associated AIH, an extremely rare immune-related comorbidity, was also reviewed.

Keywords: autoimmunity; immune tolerance; immunosuppression; thymic epithelial tumors.

Publication types

  • Review
  • Case Reports

MeSH terms

  • Autoantibodies
  • Female
  • Hepatitis, Autoimmune* / complications
  • Humans
  • Middle Aged
  • Red-Cell Aplasia, Pure* / complications
  • Thymectomy / adverse effects
  • Thymoma* / complications
  • Thymoma* / surgery
  • Thymus Neoplasms* / complications
  • Thymus Neoplasms* / surgery

Substances

  • Autoantibodies