Thymic hyperplasia as a rare etiology of pure red cell aplasia: A case report

Abstract

Introduction. Thymic hyperplasia is a rare condition caused by increase in cellular thymic mass, and in some cases is associated with pure red cell aplasia (PRCA). Case report. The patient, an 18-year-old female, was referred to hematologist due to severe transfusion dependent anemia. After full hematological work up included bone marrow biopsy a diagnosis of PRCA was made. Immunological and virological analyses were unremarkable. With history of myasthenia gravis in family and known association between this condition and thymoma, a chest magnet resonance imaging was performed revealing thymic hyperplasia, with successful clinical outcome after total thymectomy using video-assisted thoracic surgery approach. Pathohistological examination confirmed thymus hyperplasia with a simple intrathymic cyst. Following thymectomy, after 3 months the patient's hemoglobin values normalized which still persist. Conclusion. Acquired thymic hyperplasia is associated with the occurrence of autoimmune disorders. Our findings support the role of thymectomy in PRCA associated with thymic hyperplasia, but further research is needed to optimize management strategies for this rarity.