Development of thymoma without myasthenia gravis in a patient with radiographic axial spondyloarthritis treated with tumor necrosis factor-α inhibitors.

IF 1 Q4 RHEUMATOLOGY
Reumatismo Pub Date : 2025-09-17 Epub Date: 2025-06-05 DOI:10.4081/reumatismo.2025.1693
Piera Altieri, Francesco Maria Mariani, Evy Di Ruscio, Francesco Carubbi, Claudio Ferri, Alessia Alunno
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引用次数: 0

Abstract

Thymic tumors are rare in the general population, and to the best of our knowledge, no cases of thymoma have been described in patients with rheumatic diseases treated with tumor necrosis factor (TNF)-α inhibitors, except for the case of a patient receiving infliximab for Crohn's disease (CD) who developed a B2 thymoma. We describe a 60-year-old Caucasian male with radiographic axial spondyloarthritis (r-axSpA) and CD who developed an AB-type thymoma without myasthenia gravis after 18 years of treatment with TNF-α inhibitors. The patient had received the same molecule since the r-axSpA/CD diagnosis and changed it 6 months before the diagnosis of thymoma due to a disease flare. At the time of the drug switch, no mediastinal mass was present on the chest X-ray. The thymoma was surgically removed, and no additional therapy was needed. Treatment with TNF-α inhibitors was reintroduced after surgery. This case raises some important questions that remain open and deserve to be addressed in the future, such as the association between immunosuppressive therapy and thymoma and the controversial relationship between TNF-α inhibitors and myasthenia gravis.

经肿瘤坏死因子-α抑制剂治疗的轴型脊柱炎患者无重症肌无力的胸腺瘤的发展。
胸腺肿瘤在一般人群中是罕见的,据我们所知,除了克罗恩病(CD)患者接受英夫利昔单抗治疗后发生B2型胸腺瘤的病例外,还没有在接受肿瘤坏死因子(TNF)-α抑制剂治疗的风湿病患者中发生胸腺瘤的病例。我们描述了一位60岁的白人男性,患有放射状轴性脊柱炎(r-axSpA)和CD,他在接受TNF-α抑制剂治疗18年后发展为ab型胸腺瘤,但没有重症肌无力。自r-axSpA/CD诊断以来,患者接受了相同的分子,并在诊断胸腺瘤前6个月因疾病爆发而改变了它。换药时,胸片上未见纵隔肿块。胸腺瘤手术切除,不需要额外的治疗。术后再次引入TNF-α抑制剂治疗。该病例提出了一些重要的问题,这些问题仍然是开放的,值得在未来解决,例如免疫抑制治疗与胸腺瘤之间的关联以及TNF-α抑制剂与重症肌无力之间有争议的关系。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Reumatismo
Reumatismo RHEUMATOLOGY-
CiteScore
2.10
自引率
7.10%
发文量
20
审稿时长
10 weeks
期刊介绍: Reumatismo is the official Journal of the Italian Society of Rheumatology (SIR). It publishes Abstracts and Proceedings of Italian Congresses and original papers concerning rheumatology. Reumatismo is published quarterly and is sent free of charge to the Members of the SIR who regularly pay the annual fee. Those who are not Members of the SIR as well as Corporations and Institutions may also subscribe to the Journal.
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