Multiple paraneoplastic diseases associated with thymoma

Here we report a patient with a lymphoepithelial thymoma who developed in c hronological sequence limbic encephalitis, neuromyotonia and myasthenia gra vis. The patient presented with limbic encephalitis associated with an invasive thymoma and improved after surgery and cytotoxic therapy. Two months after thymectomy, neuromyotonia associated with hyperhidrosis and mild motor neur opathy occurred and the patient was given plasma-exchange and prednisone th erapy. Five months later he developed mild generalised myasthenia gravis. A nti-acetylcholine receptor antibodies, previously repeatedly negative, were found positive at the onset of clinical signs of myasthenia gravis. (C) 19 99 Elsevier Science B.V. All rights reserved.