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흉선종 환자에서 중증근무력증과 동시에 발생한 보통천포창

Pemphigus Vulgaris Simultaneously Developed with Myasthenia Gravis in Thymoma

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초록

Paraneoplatic pemphigus vularis associated with thymoma is an autoimmune disease to epithelial cell in Hassall’s corpuscle, thymus medulla and myasthenia gravis is to myoid cell in thymus cortex. Because most thymic tumor is cortex tumor, myoid cell may exposed to immune system earlier than epithelial cell and myasthenia gravis may be proceeding to pemphigus. Forty-four year old woman developed pemphigus vulgaris and myasthenia gravis simultaneously. After herbal medication, myasthenia gravis and pemphigus were worsened together. Thymoma was discovered and its WHO grade was B2. We hypothesize that in high grade thymoma, two type of different antigen could present to autoimmune mechanism simultaneously. And they could be processed together.

Abstract

Paraneoplatic pemphigus vularis associated with thymoma is an autoimmune disease to epithelial cell in Hassall’s corpuscle, thymus medulla and myasthenia gravis is to myoid cell in thymus cortex. Because most thymic tumor is cortex tumor, myoid cell may exposed to immune system earlier than epithelial cell and myasthenia gravis may be proceeding to pemphigus. Forty-four year old woman developed pemphigus vulgaris and myasthenia gravis simultaneously. After herbal medication, myasthenia gravis and pemphigus were worsened together. Thymoma was discovered and its WHO grade was B2. We hypothesize that in high grade thymoma, two type of different antigen could present to autoimmune mechanism simultaneously. And they could be processed together.

참고문헌 (4)

  1. Anhalt GJ, "Paraneoplastic pemphigus: An autoimmune mucocutaneous disease associated with neoplasia", N Engl J Med, 323, pp.1729~1735 (1990)
  2. Winkler DT, "Massthenia gravis, paraneoplastic pemphigus and thymoma, a rare triade", J Neurol, 254, pp.1601~1603 (2007)
  3. Leyn J, "Paraneoplastic pemphigus in a patient with a thymoma", Dermatol, 202, pp.151~154 (2001)
  4. Meyer S, "Thymoma, myasthenia gravis, eruptions of pemphigus vulgaris and a favourable course of relapsing melanoma: an immunological puzzle", Br J Dermatol, 155, pp.638~640 (2006)

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