Systemic lupus erythematosus associated with myasthenia gravis, pemphigus foliaceus and chronic thyroiditis after thymectomy.
A 65-year-old woman had undergone a thymectomy for thymoma and 1 year after surgery she developed scattered erosive erythema with scaling and crusting. Examination findings exhibited the elevation of anti-dsDNA antibody, anti-desmoglein 1 antibody, anti-acetylcholine receptor antibody and anti-thyroglobulin antibody. A skin biopsy showed intraepidermal blisters containing neutrophils and acantholytic keratinocytes and direct immunofluorescence revealed the deposition of immunoglobulin G in the epidermis and on the basement membrane. These findings indicated the presence of systemic lupus erythematosus (SLE), myasthenia gravis, pemphigus foliaceus and chronic thyroiditis. Only 1% of SLE patients have three other autoimmune diseases according to previous publications. Our case is rare because she suffered four autoimmune diseases after the thymectomy.
Faculty of Life Sciences, Department of Dermatology and Plastic Surgery, Kumamoto University, Kumamoto, Japan.
Soichiro
S
Sawamura
Faculty of Life Sciences, Department of Dermatology and Plastic Surgery, Kumamoto University, Kumamoto, Japan.
Ikko
I
Kajihara
Faculty of Life Sciences, Department of Dermatology and Plastic Surgery, Kumamoto University, Kumamoto, Japan.
Katsunari
K
Makino
Faculty of Life Sciences, Department of Dermatology and Plastic Surgery, Kumamoto University, Kumamoto, Japan.
Takamitsu
T
Makino
Faculty of Life Sciences, Department of Dermatology and Plastic Surgery, Kumamoto University, Kumamoto, Japan.
Satoshi
S
Fukushima
Faculty of Life Sciences, Department of Dermatology and Plastic Surgery, Kumamoto University, Kumamoto, Japan.
Masatoshi
M
Jinnin
Department of Dermatology, Kurume University School of Medicine, Kurume, Japan.
Bungo
B
Oyama
Kurume University Institute of Cutaneous Cell Biology, Kurume, Japan.
Takashi
T
Hashimoto
Faculty of Life Sciences, Department of Dermatology and Plastic Surgery, Kumamoto University, Kumamoto, Japan.
Hironobu
H
Ihn
D000368:Aged; D001327:Autoimmune Diseases / Q000209:etiology*; D005260:Female; D050031:Hashimoto Disease / Q000209:etiology; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000209:etiology; D009157:Myasthenia Gravis / Q000209:etiology; D010392:Pemphigus / Q000209:etiology; D013934:Thymectomy / Q000009:adverse effects*; D013945:Thymoma / Q000601:surgery*; D013953:Thymus Neoplasms / Q000601:surgery*; D013966:Thyroiditis / Q000209:etiology
chronic thyroiditis; myasthenia gravis; pemphigus foliaceus; systemic lupus erythematosus; thymectomy