Pemphigus foliaceus, myasthenia gravis, thymoma and red cell aplasia

A 68-year-old man developed pemphigus foliaceus, myasthenia gravis with a spindle cell thymoma, and later died with red cell aplasia. At autopsy, pemphigus affected the oesophageal mucosa, and this finding was confirmed by direct immunofluorescence. In order to clarify the relationship between pemphigus and myasthenia gravis or thymoma, sera from 38 patients with myasthenia gravis were examined. Intercellular epithelial antibodies (IC-AB) at titres of 10-40 were found in 8, when monkey oesophagus was employed as the substrate. IC-AB in sera of patients with pemphigus and or myasthenia gravis did not react to any part of human thymoma, human hyperplastic thymus or monkey normal thymus. Deposits of immunoglobulins or complement were not demonstrated in the human thymoma.