Thymoma, Pure Red Cell Aplasia, Pernicious Anaemia and Candidiasis: a Defect in Immunohomeostasis

Abstract

Summary. A patient is reported who presented with anaemia and oral candidiasis. Investigation revealed a spindle cell thymoma, and a serum inhibitor of haem synthesis associated with pure red cell aplasia. He was also shown to have the Addisonian pernicious anaemia defect, diagnosed on the basis of a depressed serum level of vitamin B12, 57Co‐cyanocobalamin absorption studies, the presence of intrinsic factor blocking antibodies and atrophic gastritis with an elevated serum gastrin level. A serum inhibitor of candida‐induced lymphocyte transformation, which may have accounted for the chronicity of the candidiasis, was also demonstrated. Following thyniectomy, whereas the antibodies to intrin..