ABSTRACT
Thymus neoplasms are frequently related to paraneoplastic autoimmune manifestations. Its most common associations are myasthenia gravis and pure red cell aplasia. Aplastic anemia has been increasingly documented as an initial presentation of thymoma. Nevertheless, its development after successful surgical resection of thymoma is a rare condition. We report a case of a 53-year-old man with severe aplastic anemia preceded by amegakaryocytic thrombocytopenia three years after thymectomy with no signs of disease recurrence. He underwent immunosuppressive therapy with cyclosporine 5 mg/kg/day and prednisone 2 mg/kg/day for six weeks. Considering the availability of a compatible donor, allogeneic stem cell transplantation was carried out. However, the patient died 11 days after transplant. A literature review was conducted, and another ten cases of aplastic anemia, diagnosed three months to four years after thymectomy, were identified. These cases suggest persistence of peripheral self-reactive T lymphocytes even years after tumor definitive treatment.
ABSTRACT
Abstract Background: Psoriatic Arthritis is the spondyloarthritis associated with psoriasis, which is often related to high mortality due to cardiovascular causes. Objectives: To quantify cardiovascular risk factors (hypertension, diabetes, dyslipidemia, obesity and smoking) and to measure risk by the Global Cardiovascular Risk Score in patients with psoriatic arthritis. Methods: Patients with psoriatic arthritis according to the Classification Criteria for Psoriatic Arthritis, aged between 30 and 74 years and without any other clinically manifest chronic inflammatory disease, atherosclerotic disease or heart failure were included. After an interview, clinical examination and data extraction from medical records, risk stratification was performed using a calculator available on the online platform of the Framingham Heart Study. We considered p < 0.05 as significant. Chi-square test and Fisher's exact test were used to compare frequencies, as well as correlation measurements. Results: 45 patients were included, 68,9% of which were women and the mean age was 53,94 years. Dyslipidemia was confirmed in approximately 93%, hypertension in 46%, obesity in 40%, 33.3% were diabetics and, 13.3%, smokers; 95% had increased abdominal circumference. It was observed that 53% had high cardiovascular risk, 29% had intermediate risk and 18% had low risk. Individuals with altered C-reactive protein and erythrocyte sedimentation rate presented, respectively, higher levels of LDL-C and total cholesterol. Conclusions: There was a high occurrence of risk factors and the majority of the sample was stratified into high or intermediate cardiovascular risk.
