[Multiorgan autoimmune syndrome: case report].
The present case report refers to a multiorgan autoimmune disease manifesting following thymectomy performed for a benign thymoma. This disease is characterized by hypothyroidism, severe myasthenia, polymyositis and alopecia which are organ-specific diseases probably with a different time of onset but which are all an expression of the same immunopathologic process occurring in individuals who have a genetic predisposition. Characteristic of the present case is not only the association of the different immunopathologic clinical pictures but also the rather difficult differential diagnosis between a hypothyroidism-related myopathy and polymyositis. It was possible to formulate the diagnosis by integrating the results of clinical and laboratory evaluation with the therapeutic outcome. The onset of the syndrome was attributed to the withdrawal, following surgery, of the inhibitory effects of the thymoma on some clones of autoreactive lymphocytes.
Divisione di Medicina Interna I, Modulo Organizzativo di Immunologia Clinica, Azienda Ospedaliera di Gallarate, VA. ghiringhellipaolo@virgilio.it
Paolo
P
Ghiringhelli
Paolo
P
Chelazzi
Giovanni
G
Chelazzi
Claudio
C
Bellintani
Simone
S
Rania
D000505:Alopecia / Q000097:blood / Q000175:diagnosis; D001327:Autoimmune Diseases / Q000097:blood* / Q000175:diagnosis* / Q000201:enzymology / Q000276:immunology; D003402:Creatine Kinase / Q000097:blood; D005260:Female; D015803:HLA-DR3 Antigen / Q000097:blood; D006801:Humans; D007037:Hypothyroidism / Q000097:blood / Q000175:diagnosis; D008875:Middle Aged; D009157:Myasthenia Gravis / Q000097:blood / Q000175:diagnosis; D017285:Polymyositis / Q000097:blood / Q000175:diagnosis
D015803:HLA-DR3 Antigen; D003402:Creatine Kinase