title: Thymoma with Concomitant Pure Red Cell Aplasia, Good's Syndrome and Myasthenia Gravis Responding to Rituximab.
abstract: Thymomas are often associated with a variety of autoimmune diseases, mostly myasthenia gravis. The association of thymomas with both pure red cell aplasia (PRCA) and Good's syndrome is exceedingly rare. To the best of our knowledge, the combination of a thymoma with manifestations of myasthenia gravis, PRCA, and Good's syndrome, as in our case herein, has not been described before in the medical literature. We present a 90-year-old man initially diagnosed with an asymptomatic thymoma. Later, he developed generalized muscle weakness and was found to have severe anemia. He was diagnosed with PRCA, myasthenia gravis and Good's syndrome. He responded to rituximab with restoration of bone marrow erythroid maturation and stabilization of red blood cell counts.
authors.affiliation: Division of Hematology-Oncology, Department of Internal Medicine, American University of Beirut Medical Center, P.O. Box 11-0236, Beirut, Lebanon.
authors.forename: Ahmad I
authors.initials: AI
authors.lastname: Antar
authors.affiliation: Department of Pathology and Immunology, Barnes-Jewish Hospital, Washington University, St. Louis, MO USA.
authors.forename: Zaher K
authors.initials: ZK
authors.lastname: Otrock
authors.affiliation: Department of Blood and Marrow Transplantation, Moffitt Cancer Center, Tampa, FL USA.
authors.forename: Mohamed A
authors.initials: MA
authors.lastname: Kharfan-Dabaja
authors.affiliation: Department of Pathology and Laboratory Medicine, American University of Beirut Medical Center, Beirut, Lebanon.
authors.forename: Rami A
authors.initials: RA
authors.lastname: Mahfouz
authors.affiliation: Division of Hematology-Oncology, Department of Internal Medicine, American University of Beirut Medical Center, P.O. Box 11-0236, Beirut, Lebanon.
authors.forename: Raafat S
authors.initials: RS
authors.lastname: Alameddine
authors.affiliation: Department of Pathology and Laboratory Medicine, American University of Beirut Medical Center, Beirut, Lebanon.
authors.forename: Nadim M W
authors.initials: NM
authors.lastname: El-Majzoub
authors.affiliation: Division of Hematology-Oncology, Department of Internal Medicine, American University of Beirut Medical Center, P.O. Box 11-0236, Beirut, Lebanon.
authors.forename: Ziad M
authors.initials: ZM
authors.lastname: Salem
keywords: Good’s syndrome; Myasthenia gravis; Pure red cell aplasia; Response; Rituximab; Thymoma