Myasthenia Gravis, Chronic Lymphocytic Leukemia, and Autoimmune Hemolytic Anemia "A Spectrum of Thymic Abnormalities?"

IT HAS been proposed recently that defects in proliferation of the lymphoid system may be associated with both immunologic deficiency and lymphoreticular malignancy and that the immunologic deficiency may predispose to such neoplasia. 1 There is also increasing evidence that the thymus may have a central role in the development of the immune system and perhaps as well as in the control of lymphocytopoeisis. 2-3 It is, therefore, of importance to note the occurrence of concomitant lymphoreticular malignancy and diseases of altered immunity in patients as further evidence of relationship. The development of chronic lymphocytic leukemia (CLL), complicated by autoimmune hemolytic anemia in a patient with myasthenia gravis (MG), a disease of presumed altered immunity 4-6 and often associated with thymic abnormalities, forms the basis of this report. Report of a Case A white man was in good health until 1930 when, at age 28, he developed diplopia, dysarthria and