Allergy Asthma Respir Dis.  2015 Sep;3(5):365-369. 10.4168/aard.2015.3.5.365.

Opportunistic lung infections as a manifestation of Good's syndrome

• Kim SY
• Kim JH
• Hwang HW
• Kim KY
• Park S
• Hwang YI
• Jang SH
• Jung KS

• KMID: 2218648
• DOI: http://doi.org/10.4168/aard.2015.3.5.365

Abstract

Good's syndrome is an acquired immunodeficiency state associated with thymoma. It is characterized by recurrent infection, autoimmune disease, and immunologic abnormality. The insufficient immunity can be managed by intravenous immunoglobulin (IVIG) replacement therapy. We describe 2 patients who presented with Pneumocystis jiroveci pneumonia and Cytomegalovirus pneumonia after thymectomy for a thymoma. Immunologic study revealed hypogammaglobulinemia with very low B-cell count, consistent with Good's syndrome. They were successfully treated with trimethoprim/sulfamethoxazole and gancyclovir respectively, and they are all well without additional infections, receiving regular IVIG replacement.

Keyword

Good's syndrome; Thymoma; Hypogammaglobulinemia; Pneumonia; Opportunistic infections

MeSH Terms

Agammaglobulinemia
Autoimmune Diseases
B-Lymphocytes
Cytomegalovirus
Ganciclovir
Humans
Immunoglobulins
Immunoglobulins, Intravenous
Lung*
Opportunistic Infections
Pneumocystis jirovecii
Pneumonia
Thymectomy
Thymoma
Ganciclovir
Immunoglobulins
Immunoglobulins, Intravenous

Figure

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  Fig. 1 Ground grass opacities and multiple patchy consolidations in both lungs at admission (A), aggravation during hospital stays (B), and improvement at discharge (C).

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  Fig. 2 Multifocal irregular shape patchy consolidation and ground glass opacities with centrilobular nodules in right middle lobe (A, B), both maxillary sinusitis (C).

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