Korean J Med.  1999 Mar;56(3):409-413.

A Case of Pernicious Anemia and Myasthenia Gravis after Thymectomy and Irradiation of an Invasive Thymoma

• Song HS
• Yun SM
• Jeon DS

Abstract

Herein we wish to report a case of pernicious anemia and myasthenia gravis occurred after treatment with removal of an invasive thymoma and irradiation. Nine years ago, the male patient was visited due to chest pain, and was found a mediastinal mass at his age of 55. He received open thoracotomy and was found stage III invasive thymoma which infiltrated phrenic nerve and pericardium. After removal of thymoma, he received 4,500cGy of radiation. Two years later, he complained of left eyelid drooping and diagnosed as myasthenia gravis with tensilon test. His myasthenic eye symptom was controled with Mestinon. After 9 years from thymectomy, he complained of dizziness and dyspnea on exertion. Bone marrow smear revealed megaloblastic anemia and serum vitamin B12 level was 42.24pg/ml. Gastric juice analysis revealed achlorhydria with positive anti-intrinsic factor antibody. 6 weeks after treatment with parenteral vitamin B12, hematologic findings were normalized.

Keyword

Invasive thymoma; Myasthenia gravis; Pernicious anemia

MeSH Terms

Achlorhydria
Anemia, Megaloblastic
Anemia, Pernicious*
Bone Marrow
Chest Pain
Dizziness
Dyspnea
Edrophonium
Eyelids
Gastric Juice
Humans
Male
Myasthenia Gravis*
Pericardium
Phrenic Nerve
Pyridostigmine Bromide
Thoracotomy
Thymectomy*
Thymoma*
Vitamin B 12
Edrophonium
Pyridostigmine Bromide
Vitamin B 12