Graft-Versus-Host-Like Disease-A Case of Thymoma-Related Erythroderma

移植物抗宿主病樣疾病－胸腺瘤關連紅皮症的病例報告

10.29784/DS.200912.0006

顏育達(Yu-Ta Yen)；何宜承(Ji-Chen Ho)；王振宇(Cheng-Yu Wang)

Thymoma ； Erythroderma ； Myasthenia gravis ； Graft-versus-host disease ； GVHD

中華皮膚科醫學雜誌

27卷4期（2009 / 12 / 01）

241 - 247

英文

移植物抗宿主病為T細胞所引起之反應，最常發生於造血幹細胞移植後。在少數情形下，胸腺瘤的病人被觀察到有類似移植物抗宿主病反應。我們描述一位58歲男性病人，在六年前被發現胸腺瘤合併重症肌無力，在未接受器官移植或輸血情形下，後來發展成移植物抗宿主病樣疾病，形成全身性癢而有鱗屑之紅皮症，併有肝功能異常。皮膚切片符合移植物抗宿主病之病理表現。我們認為胸腺瘤微環境的改變造成免疫異常，進而造成移植物抗宿主病樣疾病。

Graft-versus-host disease (GVHD) is a T-cell-mediated reaction that most commonly develops after transplantation of hematopoietic stem cells. In rare conditions, GVHD-like symptoms are observed in patients with thymoma. We present the case of a 58-year-old man with thymoma noted 6 years earlier who initially presented with myasthenia gravis and subsequently developed GVHD-like disease with symptoms of generalized itching, scaly erythroderma, and liver dysfunction. The histopathological features of a skin biopsy were consistent with those noted in the case of GVHD. We assume that the altered thymic microenvironment in thymoma patients causes immune dysregulation, leading to GVHD-like disease.