Severe Aplastic Anemia Developed after Thymectomy: A Case Report and Literature Review

Thymus neoplasms are frequently related to paraneoplastic autoimmune manifestations. Its most common associations are myasthenia gravis and pure red cell aplasia. Aplastic anemia has been increasingly documented as an initial presentation of thymoma. Nevertheless, its development after successful su...

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Main Authors: Bruna Cristine Duarte Rodrigues, Pedro José Galvão Freire, Beatriz Pinto e Siqueira Campos, Juliana Oliveira Vieira, Pedro Alves da Cruz Gouveia
Format: Article
Language:English
Published: Wiley 2020-01-01
Series:Case Reports in Hematology
Online Access:http://dx.doi.org/10.1155/2020/7819321
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author Bruna Cristine Duarte Rodrigues
Pedro José Galvão Freire
Beatriz Pinto e Siqueira Campos
Juliana Oliveira Vieira
Pedro Alves da Cruz Gouveia
author_facet Bruna Cristine Duarte Rodrigues
Pedro José Galvão Freire
Beatriz Pinto e Siqueira Campos
Juliana Oliveira Vieira
Pedro Alves da Cruz Gouveia
author_sort Bruna Cristine Duarte Rodrigues
collection DOAJ
description Thymus neoplasms are frequently related to paraneoplastic autoimmune manifestations. Its most common associations are myasthenia gravis and pure red cell aplasia. Aplastic anemia has been increasingly documented as an initial presentation of thymoma. Nevertheless, its development after successful surgical resection of thymoma is a rare condition. We report a case of a 53-year-old man with severe aplastic anemia preceded by amegakaryocytic thrombocytopenia three years after thymectomy with no signs of disease recurrence. He underwent immunosuppressive therapy with cyclosporine 5 mg/kg/day and prednisone 2 mg/kg/day for six weeks. Considering the availability of a compatible donor, allogeneic stem cell transplantation was carried out. However, the patient died 11 days after transplant. A literature review was conducted, and another ten cases of aplastic anemia, diagnosed three months to four years after thymectomy, were identified. These cases suggest persistence of peripheral self-reactive T lymphocytes even years after tumor definitive treatment.
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publishDate 2020-01-01
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series Case Reports in Hematology
spelling doaj-art-abc8d6526da745df821496ea74751c942025-08-20T02:20:13ZengWileyCase Reports in Hematology2090-65602090-65792020-01-01202010.1155/2020/78193217819321Severe Aplastic Anemia Developed after Thymectomy: A Case Report and Literature ReviewBruna Cristine Duarte Rodrigues0Pedro José Galvão Freire1Beatriz Pinto e Siqueira Campos2Juliana Oliveira Vieira3Pedro Alves da Cruz Gouveia4Internal Medicine Service, Federal University of Pernambuco, Recife, PE, BrazilInternal Medicine Service, Federal University of Pernambuco, Recife, PE, BrazilInternal Medicine Service, Federal University of Pernambuco, Recife, PE, BrazilHematology Service, Federal University of Pernambuco, Recife, PE, BrazilInternal Medicine Service, Federal University of Pernambuco, Recife, PE, BrazilThymus neoplasms are frequently related to paraneoplastic autoimmune manifestations. Its most common associations are myasthenia gravis and pure red cell aplasia. Aplastic anemia has been increasingly documented as an initial presentation of thymoma. Nevertheless, its development after successful surgical resection of thymoma is a rare condition. We report a case of a 53-year-old man with severe aplastic anemia preceded by amegakaryocytic thrombocytopenia three years after thymectomy with no signs of disease recurrence. He underwent immunosuppressive therapy with cyclosporine 5 mg/kg/day and prednisone 2 mg/kg/day for six weeks. Considering the availability of a compatible donor, allogeneic stem cell transplantation was carried out. However, the patient died 11 days after transplant. A literature review was conducted, and another ten cases of aplastic anemia, diagnosed three months to four years after thymectomy, were identified. These cases suggest persistence of peripheral self-reactive T lymphocytes even years after tumor definitive treatment.http://dx.doi.org/10.1155/2020/7819321
spellingShingle Bruna Cristine Duarte Rodrigues
Pedro José Galvão Freire
Beatriz Pinto e Siqueira Campos
Juliana Oliveira Vieira
Pedro Alves da Cruz Gouveia
Severe Aplastic Anemia Developed after Thymectomy: A Case Report and Literature Review
Case Reports in Hematology
title Severe Aplastic Anemia Developed after Thymectomy: A Case Report and Literature Review
title_full Severe Aplastic Anemia Developed after Thymectomy: A Case Report and Literature Review
title_fullStr Severe Aplastic Anemia Developed after Thymectomy: A Case Report and Literature Review
title_full_unstemmed Severe Aplastic Anemia Developed after Thymectomy: A Case Report and Literature Review
title_short Severe Aplastic Anemia Developed after Thymectomy: A Case Report and Literature Review
title_sort severe aplastic anemia developed after thymectomy a case report and literature review
url http://dx.doi.org/10.1155/2020/7819321
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