title: [Thymoma and autoimmune diseases].
abstract: The association between thymoma and autoimmunity is well known. Besides myasthenia gravis, which is found in 15 to 20% of patients with thymoma, other autoimmune diseases have been reported: erythroblastopenia, systemic lupus erythematosus, inflammatory myopathies, thyroid disorders, Isaac's syndrome or Good's syndrome. More anecdotally, Morvan's syndrome, limbic encephalitis, other autoimmune cytopenias, autoimmune hepatitis, and bullous skin diseases (pemphigus, lichen) have been reported. Autoimmune diseases occur most often before thymectomy, but they can be discovered at the time of surgery or later. Two situations require the systematic investigation of a thymoma: the occurrence of myasthenia gravis or autoimmune erythroblastopenia. Nevertheless, the late onset of systemic lupus erythematosus or the association of several autoimmune manifestations should lead to look for a thymoma. Neither the characteristics of the patients nor the pathological data can predict the occurrence of an autoimmune disease after thymectomy. Thus, thymectomy usefulness in the course of the autoimmune disease, except myasthenia gravis, has not been demonstrated. This seems to indicate the preponderant role of self-reactive T lymphocytes distributed in the peripheral immune system prior to surgery. Given the high infectious morbidity in patients with thymoma, immunoglobulin replacement therapy should be considered in patients with hypogammaglobulinemia who receive immunosuppressive therapy, even in the absence of prior infection.
authors.affiliation: Service de médecine interne, hospices civils de Lyon, hôpital de la Croix-Rousse, université Claude-Bernard - Lyon 1, 103, grande rue de la Croix-Rousse, 69004 Lyon, France. Electronic address: yvan.jamilloux@chu-lyon.fr.
authors.forename: Y
authors.initials: Y
authors.lastname: Jamilloux
authors.affiliation: Service de médecine interne, hospices civils de Lyon, hôpital de la Croix-Rousse, université Claude-Bernard - Lyon 1, 103, grande rue de la Croix-Rousse, 69004 Lyon, France.
authors.forename: H
authors.initials: H
authors.lastname: Frih
authors.affiliation: Service de médecine interne, hospices civils de Lyon, hôpital de la Croix-Rousse, université Claude-Bernard - Lyon 1, 103, grande rue de la Croix-Rousse, 69004 Lyon, France.
authors.forename: C
authors.initials: C
authors.lastname: Bernard
authors.affiliation: Service de médecine interne, hospices civils de Lyon, hôpital de la Croix-Rousse, université Claude-Bernard - Lyon 1, 103, grande rue de la Croix-Rousse, 69004 Lyon, France.
authors.forename: C
authors.initials: C
authors.lastname: Broussolle
authors.affiliation: Service de neurologie, hospices civils de Lyon, hôpital de la Croix-Rousse, université Claude-Bernard - Lyon 1, 69004 Lyon, France.
authors.forename: P
authors.initials: P
authors.lastname: Petiot
authors.affiliation: Service de pneumologie, hospices civils de Lyon, hôpital pneumologique Louis-Pradel, université Claude-Bernard - Lyon 1, 69500 Bron, France.
authors.forename: N
authors.initials: N
authors.lastname: Girard
authors.affiliation: Service de médecine interne, hospices civils de Lyon, hôpital de la Croix-Rousse, université Claude-Bernard - Lyon 1, 103, grande rue de la Croix-Rousse, 69004 Lyon, France.
authors.forename: P
authors.initials: P
authors.lastname: Sève
mesh_terms: D001327:Autoimmune Diseases / Q000145:classification / Q000453:epidemiology / Q000209:etiology*; D006801:Humans; D015994:Incidence; D012307:Risk Factors; D013945:Thymoma / Q000150:complications* / Q000453:epidemiology / Q000276:immunology; D013953:Thymus Neoplasms / Q000150:complications* / Q000453:epidemiology / Q000276:immunology
keywords: Autoimmune diseases; Good's syndrome; Lupus systémique; Maladies auto-immunes; Polymyosite; Polymyositis; Syndrome de Good; Systemic lupus; Thymoma; Thymome