Abstract
Thymomas are associated with autoantibody formation. The most common are anti-acetylcholine receptor antibodies, which correspond to myasthenia gravis (MG). Other autoantibodies, such as antistriational antibodies, can occur, but their relation to clinical syndromes is frequently uncertain. The etiology of antistriational antibodies is also poorly understood. In this case, a 61-year-old man with a history of thymoma was admitted with respiratory failure. The patient was positive for anti-acetylcholine receptor antibodies and antistriational antibodies. He developed cardiogenic shock and died within 2 days despite aggressive therapy. Laboratory studies revealed elevated cardiac enzymes and marked IgG elevation against Coxsackie A virus serotypes 9 and 24. Subclinical IgG elevations against additional Coxsackie A and Coxsackie B virus serotypes were also noted. Autopsy revealed lymphohistiocytic infiltrates with multinucleated giant cells in the myocardium and skeletal muscles, including the diaphragm. Giant cell polymyositis and myocarditis is a rare, lethal complication in patients with thymoma and MG. The pathogenesis is uncertain. An autoimmune process, possibly elicited by antistriational antibodies, has been suggested. The ...Continue Reading
References
Nov 1, 1991·Clinical and Experimental Immunology·M D Traystman, K W Beisel
Feb 1, 1988·American Heart Journal·P HumbertJ L Dupond
Dec 1, 1986·International Journal of Cardiology·M J de JongsteK I Lie
May 1, 1997·Cardiology·T MeyerA J Morguet
Apr 18, 2000·Archives of Neurology·A MyglandJ A Aarli
Aug 31, 2000·Seminars in Arthritis and Rheumatism·E D RosensteinN Kramer
Sep 16, 2009·Archives of Neurology·Shigeaki SuzukiNorihiro Suzuki
Aug 28, 2010·Journal of the American College of Cardiology·Mirae LeeEun-Seok Jeon
Feb 15, 2011·Cellular & Molecular Immunology·Shahar ShellyYehuda Shoenfeld
Jul 15, 2011·Expert Opinion on Therapeutic Targets·Jun-Ichi SuzukiMitsuaki Isobe
May 25, 2012·Journal of Clinical Neuromuscular Disease·Sandeep S RanaBrenda Adamovich
Jun 29, 2012·Oncology Letters·Hidefumi SasakiYoshitaka Fujii
Aug 14, 2012·Expert Review of Clinical Immunology·Matthew N Meriggioli, Donald B Sanders
Sep 20, 2012·Neuropathology : Official Journal of the Japanese Society of Neuropathology·Tomoya KonKoichi Wakabayashi
Jul 9, 2013·European Journal of Neurology : the Official Journal of the European Federation of Neurological Societies·S SuzukiN Suzuki
Aug 7, 2014·Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia·Jie LinJiahong Lu
Sep 27, 2015·Autoimmunity Reviews·C BernardP Sève
Jan 19, 2016·International Journal of Cardiology·Yuki IkedaJunya Ako
Mar 26, 2016·Korean Circulation Journal·Josef Finsterer, Claudia Stöllberger
Citations
Dec 11, 2020·Orbit·Rachel Jui-Chi ChangZelda S Pick
Feb 26, 2021·Clinical Rheumatology·Frank A ScangarelloRobert Kalish
Jun 10, 2021·Brain and Behavior·Wei ChengPing Chen