系统性红斑狼疮合并胸腺瘤3例并文献复习

Systemic lupus erythematosus with thymoma:three cases and literature review

目的探讨系统性红斑狼疮(SLE)与胸腺瘤之间的关系及此类患者的治疗策略。方法回顾性分析3例系统性红斑狼疮合并胸腺瘤患者的临床资料,并进行文献复习,就两者之间的联系及治疗策略进行讨论。结果 3例患者均为女性,发生胸腺瘤时年龄40～45岁。2例患者首次诊断SLE时即伴发胸腺瘤,1例患者胸腺瘤发生于SLE确诊后2年。2例患者明确行胸腺瘤切除术。2例患者给予激素合并免疫抑制剂治疗。结论对于中老年SLE患者要警惕胸腺瘤的发生,对胸腺瘤的患者要监测自身免疫病的发生。糖皮质激素及免疫抑制剂联合治疗仍适用于合并胸腺瘤的SLE患者,应根据胸腺瘤的病理分型给予积极的治疗。切除胸腺瘤对于SLE的预后影响不明确,两者之间的机制需要进一步探索。

【Objective】To explore the relationship between systemic lupus erythematosus（SLE） and thymoma and the treatment strategy for these patients.【Methods】The clinical data of three SLE patients with thymoma was reported,and the link between the two was discussed after a review of the literature.【Results】Three patients were female with an age range from 40 to 45 years old when they occurred as thymoma.Two patients were diagnosed with SLE and thymoma at the same time.One patient＇s thymoma appeared two years later than the diagnosis of SLE.Two patients were given thymoma resection.Two patients were given glucocorticoid and immunosuppressant therapy.【Conclusion】The possibility of thymoma should be considered among those late-onset SLE patients.And we should monitor the occurrence of autoimmune disease in patients with thymoma.Glucocorticoid and immunosuppressant combination therapy is still applicable to SLE patients with thymoma.The prognosis of SLE patients after the thymoma resection is not determined.The mechanism between SLE and thymoma needs further exploration.