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침윤성 흉선종치료후 발생된 중증근무력증 및 악성빈혈 1예
송홍석,윤상미,전동석 대한내과학회 1999 대한내과학회지 Vol.56 No.3
Herein we wish to report a case of pernicious anemia and myasthenia gravis occurred after treatment with removal of an invasive thymoma and irradiation. Nine years ago, the male patient was visited due to chest pain, and was found a mediastinal mass at his age of 55. He received open thoracotomy and was found stage III invasive thymoma which infiltrated phrenic nerve and pericardium. After removal of thymoma, he received 4,500cGy of radiation. Two years later, he complained of left eyelid drooping and diagnosed as myasthenia gravis with tensilon test. His myasthenic eye symptom was controled with Mestinon. After 9 years from thymectomy, he complained of dizziness and dyspnea on exertion. Bone marrow smear revealed megaloblastic anemia and serum vitamin B12 level was 42.24pg/ml. Gastric juice analysis revealed achlorhydria with positive anti-intrinsic factor antibody. 6 weeks after treatment with parenteral vitamin B12, hematologic findings were normalized.