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.