Hypothermia, hyperhidrosis, myokymia and increased urinary excretion of catecholamines associated with a thymoma.

OBJECTIVE

To report a rare syndrome associated with a thymoma and its first successful treatment with gammaglobulin.

CLINICAL FEATURES: A 49-year-old white male presented with marked hypothermia, hyperhidrosis, myokymia and increased urinary excretion of catecholamines four weeks after complete excision of a malignant thymoma. He became increasingly drowsy, obtunded and required ventilatory support.

INTERVENTION AND OUTCOME: A catecholamine secreting tumour was excluded and he was treated with intravenous gammaglobulin for five days, with dramatic improvement in his condition. Six months later he remains in remission.

CONCLUSION

The response to treatment in this patient suggests an immunological pathogenesis for this rare group of symptoms associated with a thymoma.