Korean J Intern Med.  2008 Dec;23(4):219-222. 10.3904/kjim.2008.23.4.219.

A case of granulomatous lung disease in a patient with Good's syndrome

• Lee SH
• Lee SM
• Yang SC
• Yoo CG
• Kim YW
• Shim YS
• Han SK

• KMID: 1100772
• DOI: http://doi.org/10.3904/kjim.2008.23.4.219

Abstract

Good's syndrome is extremely rare. This adult-onset condition is characterized by a thymoma with immunodeficiency, low B- and T-cell counts, and hypo-gammaglobulinemia. The initial clinical presentation is either a mass-lesion thymoma or a recurrent infection. Patients with Good's syndrome are very susceptible to infections; common respiratory and opportunistic infections can be life-threatening. There are no reports of granulomatous lung disease in patients with Good's syndrome, although it has been observed in patients with common variable immunodeficiency, of which Good's syndrome is a subset. We describe a 53-year-old male thymoma patient who presented with respiratory symptoms caused by granulomatous lung disease and an opportunistic infection. He died of uncontrolled fungal infection despite repeated intravenous immunoglobulin and supportive care. Clinicians should look for evidence of immunologic dysfunction in thymoma patients presenting with severe recurrent infections, especially opportunistic infections.

Keyword

Thymoma, Immunodeficiency; Opportunistic infection

MeSH Terms

Fatal Outcome
Granuloma, Respiratory Tract/diagnosis/*etiology/therapy
Humans
Immunologic Deficiency Syndromes/*complications/immunology/pathology
Lung Diseases/diagnosis/*etiology/therapy
Male
Middle Aged
Thymoma/*complications/immunology/pathology
Thymus Neoplasms/*complications/immunology/pathology