A case report of giant cell myocarditis and myositis observed during the clinical course of invasive thymoma associated with myasthenia gravis

Norio Tanahashi, Hideki Sato, Shigeru Nogawa, Toru Satoh, Masafumi Kawamura, Masayuki Shimoda

Research output: Contribution to journalArticle

29 Citations (Scopus)

Abstract

The patient is a 62-year-old man who was diagnosed with myasthenia gravis and invasive thymoma at the age of 45 years, and had received treatment by extended thymectomy and radiotherapy. At the age of 61, he had suffered from a myasthenic crisis, and been administered immunoadsorption therapy under managed ventilatory care. Treatment had then been continued with steroids; however, due to subsequent deterioration of his diabetic state, treatment was switched to the immunosuppressant drug tacrolimus. Three months after the commencement of tacrolimus administration, the patient developed generalized malaise and dyspnea. The serum creatine phosphokinase (CPK) level was abnormally elevated, and abnormal electrocardiographic findings were noted, including atrioventricular dissociation and ventricular escape contraction. Steroid pulse therapy was therefore initiated, however, 4 days later, the patient suddenly died. Autopsy examination revealed inflammatory cell infiltration with giant cells in the myocardium, diffuse myocardial degeneration, and polymyositis. The case was therefore considered as one with the syndrome of myasthenia gravis, polymyositis, giant cell myocarditis, and thymoma.

Original languageEnglish
Pages (from-to)30-42
Number of pages13
JournalKeio Journal of Medicine
Volume53
Issue number1
Publication statusPublished - 2004 Mar

Fingerprint

Myositis
Thymoma
Myasthenia Gravis
Myocarditis
Giant Cells
Polymyositis
Tacrolimus
Steroids
Therapeutics
Thymectomy
Heart Block
Muscle Weakness
Managed Care Programs
Immunosuppressive Agents
Creatine Kinase
Dyspnea
Autopsy
Myocardium
Radiotherapy
Serum

Keywords

  • Giant cell myocarditis
  • Myasthenia gravis
  • Polymyositis
  • Thymoma

ASJC Scopus subject areas

  • Medicine(all)

Cite this

A case report of giant cell myocarditis and myositis observed during the clinical course of invasive thymoma associated with myasthenia gravis. / Tanahashi, Norio; Sato, Hideki; Nogawa, Shigeru; Satoh, Toru; Kawamura, Masafumi; Shimoda, Masayuki.

In: Keio Journal of Medicine, Vol. 53, No. 1, 03.2004, p. 30-42.

Research output: Contribution to journalArticle

Tanahashi, Norio ; Sato, Hideki ; Nogawa, Shigeru ; Satoh, Toru ; Kawamura, Masafumi ; Shimoda, Masayuki. / A case report of giant cell myocarditis and myositis observed during the clinical course of invasive thymoma associated with myasthenia gravis. In: Keio Journal of Medicine. 2004 ; Vol. 53, No. 1. pp. 30-42.
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