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Erschienen in: Der Nervenarzt 6/2009

01.06.2009 | Originalien

Thymomassoziierte Polymyositis

verfasst von: Dr. B. Jordan, K. Eger, S. Zierz

Erschienen in: Der Nervenarzt | Ausgabe 6/2009

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Zusammenfassung

Neuromuskuläre Begleiterkrankungen eines Thymoms sind die Myasthenia gravis, die Polymyositis, die Dermatomyositis sowie die Neuromyotonie. Während 50% der Thymompatienten eine Myasthenia gravis entwickeln, ist die Polymyositis mit einer Häufigkeit von weniger als 5% bei Thymomen als paraneoplastische Erkrankung kaum bekannt.
Es wird ein Patient mit Thymom, Polymyositis und Myasthenia gravis vorgestellt. Bei gleichzeitigem Bestehen von Myositis und Myasthenia gravis vermischen sich die diagnostischen Kriterien (Serum-CK, EMG, Augenbeteiligung) beider Erkrankungen. Dies kann die Diagnose und damit auch die Therapie beider Erkrankungen erheblich erschweren.
Literatur
1.
Zurück zum Zitat Ago T, Nakamura M, Iwata I et al (1999) Dermatomyositis associated with invasive thymoma. Intern Med 38:155–159PubMedCrossRef Ago T, Nakamura M, Iwata I et al (1999) Dermatomyositis associated with invasive thymoma. Intern Med 38:155–159PubMedCrossRef
2.
Zurück zum Zitat Avni I, Sharabi Y, Sadeh M, Buchman AS (2006) Eosinophilia, myositis and myasthenia gravis associated with a thymoma. Muscle Nerve 34:242–245PubMedCrossRef Avni I, Sharabi Y, Sadeh M, Buchman AS (2006) Eosinophilia, myositis and myasthenia gravis associated with a thymoma. Muscle Nerve 34:242–245PubMedCrossRef
3.
Zurück zum Zitat Budde JM, Morris CD, Gal AA et al (2001) Predictors of outcome in thymectomy for myasthenia gravis. Ann Thorac Surg 72:197–202PubMedCrossRef Budde JM, Morris CD, Gal AA et al (2001) Predictors of outcome in thymectomy for myasthenia gravis. Ann Thorac Surg 72:197–202PubMedCrossRef
4.
Zurück zum Zitat Chen G, Marx A, Wen-Hu C et al (2002) New WHO histologic classification predicts prognosis of thymic epithelial tumors: A clinicopathologic study of 200 thymoma cases from China. Cancer 95:420–429PubMedCrossRef Chen G, Marx A, Wen-Hu C et al (2002) New WHO histologic classification predicts prognosis of thymic epithelial tumors: A clinicopathologic study of 200 thymoma cases from China. Cancer 95:420–429PubMedCrossRef
5.
Zurück zum Zitat Evoli A, Minicuci GM, Vitaliani R et al (2007) Paraneoplastic diseases associated with thymoma. J Neurol 254:756–762PubMedCrossRef Evoli A, Minicuci GM, Vitaliani R et al (2007) Paraneoplastic diseases associated with thymoma. J Neurol 254:756–762PubMedCrossRef
6.
Zurück zum Zitat Evoli A, Minisci C, Di Schino C et al (2002) Thymoma in patients with MG: Characteristics and long-term outcome. Neurology 59:1844–1850PubMed Evoli A, Minisci C, Di Schino C et al (2002) Thymoma in patients with MG: Characteristics and long-term outcome. Neurology 59:1844–1850PubMed
7.
8.
Zurück zum Zitat Hengstman GJ, Drost G, Wagenaar M, van Engelen BG (2006) Persistent increased risk for thymoma in myasthenia gravis associated with myositis. Muscle Nerve 34:251–252PubMedCrossRef Hengstman GJ, Drost G, Wagenaar M, van Engelen BG (2006) Persistent increased risk for thymoma in myasthenia gravis associated with myositis. Muscle Nerve 34:251–252PubMedCrossRef
9.
Zurück zum Zitat Herrmann DN, Blaivas M, Wald JJ, Feldman EL (2000) Granulomatous myositis, primary biliary cirrhosis, pancytopenia, and thymoma. Muscle Nerve 23:1133–1136PubMedCrossRef Herrmann DN, Blaivas M, Wald JJ, Feldman EL (2000) Granulomatous myositis, primary biliary cirrhosis, pancytopenia, and thymoma. Muscle Nerve 23:1133–1136PubMedCrossRef
10.
Zurück zum Zitat Inoue M, Kojima Y, Shinde A et al (2007) Concurrence of myasthenia gravis, polymyositis, thyroiditis and eosinophilia in a patient with type B1 thymoma. Rinsho Shinkeigaku 47:423–428PubMed Inoue M, Kojima Y, Shinde A et al (2007) Concurrence of myasthenia gravis, polymyositis, thyroiditis and eosinophilia in a patient with type B1 thymoma. Rinsho Shinkeigaku 47:423–428PubMed
11.
Zurück zum Zitat Katabami S, Sugiyama T, Kodama T et al (1995) Polymyositis associated with thymoma and the subsequent development of pure red cell aplasia. Intern Med 34:569–573PubMedCrossRef Katabami S, Sugiyama T, Kodama T et al (1995) Polymyositis associated with thymoma and the subsequent development of pure red cell aplasia. Intern Med 34:569–573PubMedCrossRef
12.
Zurück zum Zitat Marx A, Muller-Hermelink HK (1999) From basic immunobiology to the upcoming WHO-classification of tumors of the thymus. The second conference on biological and clinical aspects of thymic epithelial tumors and related recent developments. Pathol Res Pract 195:515–533PubMed Marx A, Muller-Hermelink HK (1999) From basic immunobiology to the upcoming WHO-classification of tumors of the thymus. The second conference on biological and clinical aspects of thymic epithelial tumors and related recent developments. Pathol Res Pract 195:515–533PubMed
13.
Zurück zum Zitat Milani M, Ostlie N, Wang W, Conti-Fine BM (2003) T cells and cytokines in the pathogenesis of acquired myasthenia gravis. Ann N Y Acad Sci 998:284–307PubMedCrossRef Milani M, Ostlie N, Wang W, Conti-Fine BM (2003) T cells and cytokines in the pathogenesis of acquired myasthenia gravis. Ann N Y Acad Sci 998:284–307PubMedCrossRef
15.
Zurück zum Zitat Mygland A, Vincent A, Newsom-Davis J et al (2000) Autoantibodies in thymoma-associated myasthenia gravis with myositis or neuromyotonia. Arch Neurol 57:527–531PubMedCrossRef Mygland A, Vincent A, Newsom-Davis J et al (2000) Autoantibodies in thymoma-associated myasthenia gravis with myositis or neuromyotonia. Arch Neurol 57:527–531PubMedCrossRef
16.
Zurück zum Zitat Okumura M, Shiono H, Minami M et al (2008) Clinical and pathological aspects of thymic epithelial tumors. Gen Thorac Cardiovasc Surg 56:10–16PubMedCrossRef Okumura M, Shiono H, Minami M et al (2008) Clinical and pathological aspects of thymic epithelial tumors. Gen Thorac Cardiovasc Surg 56:10–16PubMedCrossRef
17.
Zurück zum Zitat Raschilas F, Mouthon L, Andre MH et al (1999) Concomitant polymyositis and myasthenia gravis reveal malignant thymoma. A case report and review of the literature. Ann Med Interne (Paris) 150:370–373 Raschilas F, Mouthon L, Andre MH et al (1999) Concomitant polymyositis and myasthenia gravis reveal malignant thymoma. A case report and review of the literature. Ann Med Interne (Paris) 150:370–373
18.
Zurück zum Zitat Rini BI, Gajewski TF (1999) Polymyositis with respiratory muscle weakness requiring mechanical ventilation in a patient with metastatic thymoma treated with octreotide. Ann Oncol 10:973–979PubMedCrossRef Rini BI, Gajewski TF (1999) Polymyositis with respiratory muscle weakness requiring mechanical ventilation in a patient with metastatic thymoma treated with octreotide. Ann Oncol 10:973–979PubMedCrossRef
19.
Zurück zum Zitat Saeki S, Fukusako T, Negoro K et al (1996) Polymyositis followed by myasthenia gravis. Nippon Ronen Igakkai Zasshi 33:532–534PubMed Saeki S, Fukusako T, Negoro K et al (1996) Polymyositis followed by myasthenia gravis. Nippon Ronen Igakkai Zasshi 33:532–534PubMed
20.
Zurück zum Zitat Smit EF (2008) Thymic malignancies. Ann Oncol 19 [Suppl 7]:309–312 Smit EF (2008) Thymic malignancies. Ann Oncol 19 [Suppl 7]:309–312
21.
Zurück zum Zitat Souadjian JV, Enriquez P, Silverstein MN, Pepin JM (1974) The spectrum of diseases associated with thymoma. Coincidence or syndrome? Arch Intern Med 134:374–379PubMedCrossRef Souadjian JV, Enriquez P, Silverstein MN, Pepin JM (1974) The spectrum of diseases associated with thymoma. Coincidence or syndrome? Arch Intern Med 134:374–379PubMedCrossRef
22.
Zurück zum Zitat van de Warrenburg BP, Hengstman GJ, Vos PE et al (2002) Concomitant dermatomyositis and myasthenia gravis presenting with respiratory insufficiency. Muscle Nerve 25:293–296CrossRef van de Warrenburg BP, Hengstman GJ, Vos PE et al (2002) Concomitant dermatomyositis and myasthenia gravis presenting with respiratory insufficiency. Muscle Nerve 25:293–296CrossRef
23.
Zurück zum Zitat Weiller PJ, Durand JM, Prince-Zucchelli MA et al (1984) Association of polymyositis, myasthenia, and thymoma. A case and review of the literature. Ann Med Interne (Paris) 135:299–304 Weiller PJ, Durand JM, Prince-Zucchelli MA et al (1984) Association of polymyositis, myasthenia, and thymoma. A case and review of the literature. Ann Med Interne (Paris) 135:299–304
24.
Zurück zum Zitat Zamecnik J, Vesely D, Jakubicka B et al (2007) Muscle lymphocytic infiltrates in thymoma-associated myasthenia gravis are phenotypically different from those in polymyositis. Neuromuscul Disord 17:935–942PubMedCrossRef Zamecnik J, Vesely D, Jakubicka B et al (2007) Muscle lymphocytic infiltrates in thymoma-associated myasthenia gravis are phenotypically different from those in polymyositis. Neuromuscul Disord 17:935–942PubMedCrossRef
Metadaten
Titel
Thymomassoziierte Polymyositis
verfasst von
Dr. B. Jordan
K. Eger
S. Zierz
Publikationsdatum
01.06.2009
Verlag
Springer-Verlag
Erschienen in
Der Nervenarzt / Ausgabe 6/2009
Print ISSN: 0028-2804
Elektronische ISSN: 1433-0407
DOI
https://doi.org/10.1007/s00115-009-2689-1

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