{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T17:04:38Z","timestamp":1784307878028,"version":"3.55.0"},"reference-count":30,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T00:00:00Z","timestamp":1781049600000},"content-version":"vor","delay-in-days":9,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Case Reports"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Thymomas are epithelial tumors of the anterior mediastinum and are frequently associated with paraneoplastic autoimmune disorders. Pure red cell aplasia (PRCA) is a rare but clinically significant complication, caused by immune\u2010mediated suppression of erythropoiesis. We report a case of a 52\u2010year\u2010old male with a previously diagnosed but untreated thymoma, who presented after 9\u2009years with severe normocytic, normochromic anemia and reticulocytopenia. Bone marrow examination revealed selective erythroid suppression with preservation of myeloid and megakaryocytic lineages, consistent with PRCA. Imaging demonstrated a large anterior mediastinal mass measuring 16\u2009cm. The patient received supportive blood transfusions followed by surgical thymectomy. Histopathological and immunohistochemical analysis confirmed a mixed spindle cell thymoma (Type A\/AB). Postoperatively, the patient achieved complete hematological recovery without additional immunosuppressive therapy. This case highlights that thymoma\u2010associated PRCA may present as an isolated paraneoplastic manifestation without neuromuscular symptoms. It underscores the crucial role of thymectomy in restoring erythropoiesis and achieving transfusion independence. To our knowledge, this is the first reported case of thymoma\u2010associated PRCA in Syria, providing valuable insight for clinicians managing similar rare presentations.<\/jats:p>","DOI":"10.1002\/ccr3.72888","type":"journal-article","created":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T05:41:50Z","timestamp":1781156510000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Pure Red Cell Aplasia as an Isolated Paraneoplastic Manifestation of Thymoma: A Case Report and Literature Review"],"prefix":"10.1002","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-6019-2560","authenticated-orcid":false,"given":"Heba","family":"Amer","sequence":"first","affiliation":[{"name":"Damascus University, Faculty of Medicine  Damascus Syrian Arab Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-4190-9745","authenticated-orcid":false,"given":"Modar","family":"Alajlani","sequence":"additional","affiliation":[{"name":"Damascus University, Faculty of Medicine  Damascus Syrian Arab Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mhd Rashad","family":"Jamle","sequence":"additional","affiliation":[{"name":"Damascus University, Faculty of Medicine  Damascus Syrian Arab Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hareth","family":"Almanfe","sequence":"additional","affiliation":[{"name":"Latakia University, Faculty of Medicine  Latakia Syrian Arab Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammad","family":"Shbat","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery Al Mouwasat Hospital  Damascus Syrian Arab Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammad Abd Alrahman","family":"Saif","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery Al Mouwasat Hospital  Damascus Syrian Arab Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anas","family":"Abdulrazzak","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery Al Mouwasat Hospital  Damascus Syrian Arab Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed","family":"Nabhan","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery Al Mouwasat Hospital  Damascus Syrian Arab Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bassam","family":"Darwish","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery Al Mouwasat Hospital  Damascus Syrian Arab Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,6,10]]},"reference":[{"key":"e_1_2_14_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12288\u2010014\u20100478\u2010x"},{"key":"e_1_2_14_3_1","first-page":"557","article-title":"Zur Entstehung der Blut Plattchen","volume":"34","author":"Kaznelson P.","year":"1922","journal-title":"Verhandlungen der Deutschen Gesellschaft f\u00fcr Innere Medizin"},{"key":"e_1_2_14_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12055\u2010021\u201001273\u20103"},{"key":"e_1_2_14_5_1","doi-asserted-by":"publisher","DOI":"10.3390\/cancers13071559"},{"key":"e_1_2_14_6_1","doi-asserted-by":"publisher","DOI":"10.1038\/cmi.2010.74"},{"key":"e_1_2_14_7_1","doi-asserted-by":"publisher","DOI":"10.1093\/icvts\/ivab301"},{"key":"e_1_2_14_8_1","doi-asserted-by":"publisher","DOI":"10.4081\/cp.2011.e1"},{"key":"e_1_2_14_9_1","unstructured":"A.Meneshian K. R.Olivier andJ. R.Molina \u201cClinical Presentation and Management of Thymoma and Thymic Carcinoma \u201dhttps:\/\/www.uptodate.com\/contents\/clinical\u2010presentation\u2010and\u2010management\u2010of\u2010thymoma\u2010and\u2010thymic\u2010carcinoma."},{"key":"e_1_2_14_10_1","unstructured":"T. K.Lahiri D.Agrawal K.Agrawal andJ.Shukla \u201cPure Red Cell Aplasia Associated With Thymoma \u201dhttps:\/\/pubmed.ncbi.nlm.nih.gov\/12437240\/."},{"key":"e_1_2_14_11_1","doi-asserted-by":"publisher","DOI":"10.21037\/gs\u201022\u2010218"},{"key":"e_1_2_14_12_1","doi-asserted-by":"publisher","DOI":"10.1259\/bjr.20180598"},{"key":"e_1_2_14_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jasc.2020.04.006"},{"key":"e_1_2_14_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.JTO.0000263705.23579"},{"key":"e_1_2_14_15_1","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.76750"},{"key":"e_1_2_14_16_1","doi-asserted-by":"publisher","DOI":"10.21037\/jtd.2018.07.14"},{"key":"e_1_2_14_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/1759\u20107714.70157"},{"key":"e_1_2_14_18_1","doi-asserted-by":"publisher","DOI":"10.1159\/000542915"},{"key":"e_1_2_14_19_1","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.39387"},{"key":"e_1_2_14_20_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12055\u2010019\u201000875\u20102"},{"key":"e_1_2_14_21_1","doi-asserted-by":"publisher","DOI":"10.26442\/00403660.2019.07.000326"},{"issue":"10","key":"e_1_2_14_22_1","first-page":"373","article-title":"A Ring\u2010Calcified Thymoma, Mimicking Pericardial Cyst, Precedes Pure Red Cell Aplasia for More Than 10\u2009Years \u2010 A Case\u2010Based Overview of Pathophysiology","volume":"77","author":"Graaf M. 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