A case of synchronous triple autoimmune disorders secondary to thymoma: Pure red cell aplasia, Good's syndrome, and thymoma-associated multi-organ autoimmunity

Yuta Nakagawa; Kinnosuke Matsumoto; Makoto Yamamoto; Haruhiko Hirata; Takayuki Shiroyama; Kotaro Miyake; Yuji Yamamoto; Tomoki Kuge; Midori Yoneda; Yujiro Naito; Yasuhiko Suga; Kiyoharu Fukushima; Shohei Koyama; Kota Iwahori; Izumi Nagatomo; Yoshito Takeda; Atsushi Kumanogoh

doi:10.1016/j.rmcr.2022.101619

A case of synchronous triple autoimmune disorders secondary to thymoma: Pure red cell aplasia, Good's syndrome, and thymoma-associated multi-organ autoimmunity

Respir Med Case Rep. 2022 Feb 23:36:101619. doi: 10.1016/j.rmcr.2022.101619. eCollection 2022.

Authors

Yuta Nakagawa¹, Kinnosuke Matsumoto¹, Makoto Yamamoto¹, Haruhiko Hirata¹, Takayuki Shiroyama¹, Kotaro Miyake¹, Yuji Yamamoto¹, Tomoki Kuge¹, Midori Yoneda¹, Yujiro Naito¹, Yasuhiko Suga¹, Kiyoharu Fukushima¹, Shohei Koyama¹, Kota Iwahori¹, Izumi Nagatomo¹, Yoshito Takeda¹, Atsushi Kumanogoh^{1

2

3

4}

Affiliations

¹ Department of Respiratory Medicine and Clinical Immunology, Graduate School of Medicine, Osaka University, 2-2 Yamadaoka, Suita City, Osaka, 565-0871, Japan.
² Department of Immunopathology, WPI, Immunology Frontier Research Center (iFReC), Osaka University, 3-3-1 Yamadaoka, Suita City, Osaka, 565-0871, Japan.
³ Integrated Frontier Research for Medical Science Division, Institute for Open and Transdisciplinary Research Initiatives(OTRI), Osaka University, 2-1 Yamadaoka, Suita City, Osaka, 565-0871, Japan.
⁴ Center for Infectious Disease for Education and Research (CiDER), Osaka University, 2-8 Yamadaoka, Suita City, Osaka, 565-0871, Japan.

Abstract

Pure red cell aplasia (PRCA), Good's syndrome (GS), and thymoma-associated multiorgan autoimmunity (TAMA) are associated with thymoma. Herein, we describe the case of a 56-year-old woman with PRCA, GS, and TAMA simultaneously. She was treated with cyclosporine, immunoglobulin supplementation, and prednisolone; however, she died of uncontrolled sepsis due to extreme immunosuppression. The combination of these three diseases is likely to lead to fatal infections, and to avoid such infections, it may be necessary to reduce or discontinue immunosuppressants and steroids as soon as possible if the diseases are controlled, as well as regular immunoglobulin supplementation.

Keywords: Good's syndrome; Pure red cell aplasia; Thymoma; Thymoma-associated multi-organ autoimmunity.

Publication types

Case Reports