Zusammenfassung
Neuromuskuläre Begleiterkrankungen eines Thymoms sind die Myasthenia gravis, die Polymyositis, die Dermatomyositis sowie die Neuromyotonie. Während 50% der Thymompatienten eine Myasthenia gravis entwickeln, ist die Polymyositis mit einer Häufigkeit von weniger als 5% bei Thymomen als paraneoplastische Erkrankung kaum bekannt.
Es wird ein Patient mit Thymom, Polymyositis und Myasthenia gravis vorgestellt. Bei gleichzeitigem Bestehen von Myositis und Myasthenia gravis vermischen sich die diagnostischen Kriterien (Serum-CK, EMG, Augenbeteiligung) beider Erkrankungen. Dies kann die Diagnose und damit auch die Therapie beider Erkrankungen erheblich erschweren.
Summary
Neuromuscular diseases accompanying thymoma include myasthenia gravis, polymyositis, dermatomyositis, and neuromyotonia. Usually 50% of patients with thymoma develop myasthenia gravis. However, only 5% show polymyositis as an accompanying paraneoplastic phenomenon. We report the case of a patient with thymoma showing myasthenia gravis as well as polymyositis. Due to the simultaneous occurrence of these paraneoplastic diseases, the criteria for exact diagnosis (serum creatine kinase, EMG, ocular involvement) overlap. This diagnostic dilemma can appreciably complicate the therapeutic approach.
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Jordan, B., Eger, K. & Zierz, S. Thymomassoziierte Polymyositis. Nervenarzt 80, 708–711 (2009). https://doi.org/10.1007/s00115-009-2689-1
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DOI: https://doi.org/10.1007/s00115-009-2689-1