Piera Altieri, Francesco Maria Mariani, Evy Di Ruscio, Francesco Carubbi, Claudio Ferri, Alessia Alunno
{"title":"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。","authors":"Piera Altieri, Francesco Maria Mariani, Evy Di Ruscio, Francesco Carubbi, Claudio Ferri, Alessia Alunno","doi":"10.4081/reumatismo.2025.1693","DOIUrl":null,"url":null,"abstract":"<p><p>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.</p>","PeriodicalId":21222,"journal":{"name":"Reumatismo","volume":" ","pages":""},"PeriodicalIF":1.0000,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Development of thymoma without myasthenia gravis in a patient with radiographic axial spondyloarthritis treated with tumor necrosis factor-α inhibitors.\",\"authors\":\"Piera Altieri, Francesco Maria Mariani, Evy Di Ruscio, Francesco Carubbi, Claudio Ferri, Alessia Alunno\",\"doi\":\"10.4081/reumatismo.2025.1693\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>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.</p>\",\"PeriodicalId\":21222,\"journal\":{\"name\":\"Reumatismo\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":1.0000,\"publicationDate\":\"2025-09-17\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Reumatismo\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.4081/reumatismo.2025.1693\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/6/5 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q4\",\"JCRName\":\"RHEUMATOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Reumatismo","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.4081/reumatismo.2025.1693","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/6/5 0:00:00","PubModel":"Epub","JCR":"Q4","JCRName":"RHEUMATOLOGY","Score":null,"Total":0}
Development of thymoma without myasthenia gravis in a patient with radiographic axial spondyloarthritis treated with tumor necrosis factor-α inhibitors.
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.
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.