Giant Cell Polymyositis and Myocarditis in a Patient With Thymoma and Myasthenia Gravis: A Postviral Autoimmune Process?

Journal of Neuropathology and Experimental Neurology
David S PriemerSunil S Badve

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
May 1, 1997·Cardiology·T MeyerA J Morguet
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
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
Mar 26, 2016·Korean Circulation Journal·Josef Finsterer, Claudia Stöllberger

❮ Previous
Next ❯

Related Concepts

Related Feeds

Autoimmune Diseases

Autoimmune diseases occur as a result of an attack by the immune system on the body’s own tissues resulting in damage and dysfunction. There are different types of autoimmune diseases, in which there is a complex and unknown interaction between genetics and the environment. Discover the latest research on autoimmune diseases here.

Cardiogenic Shock

Cardiogenic shock is a devastating consequence of acute myocardial infarction and is associated with an extremely high mortality. Here is the latest research.