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Clinics and Practice
Volume 9
Issue 2
10.4081/cp.2019.1112
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Clinics and Practice is published by MDPI from Volume 11 Issue 1 (2021). Previous articles were published by another publisher in Open Access under a CC-BY (or CC-BY-NC-ND) licence, and they are hosted by MDPI on mdpi.com as a courtesy and upon agreement with PAGEPress.
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Case Report

Good’s Syndrome, a Rare form of Acquired Immunodeficiency Associated with Thymomas

by
Antonio Tamburello
1,*,
Laura Castelnovo
1,
Paola Faggioli
1,
Daniela Bompane
1,
Bruno Brando
2,
Arianna Gatti
2,
Lucia Roncoroni
3,
Biancamaria Di Marco
3 and
Antonino Mazzone
1
1
Department of Internal Medicine, Hospital of Legnano, Legnano (MI), Italy
2
Hematology Laboratory and Transfusion Center, Hospital of Legnano, Legnano (MI), Italy
3
Department of Anatomical Pathology, Hospital of Legnano, Legnano (MI), Italy
*
Author to whom correspondence should be addressed.
Clin. Pract. 2019, 9(2), 1112; https://doi.org/10.4081/cp.2019.1112
Submission received: 6 November 2018 / Revised: 11 April 2019 / Accepted: 12 April 2019 / Published: 5 June 2019

Abstract

Good’s syndrome (GS) or thymomaassociated immunodeficiency is a rare clinical entity that should be ruled out in patients with thymoma who develop severe, recurrent bacterial infections and opportunistic viral and fungal infections. There are no treatment protocols established, hence, early recognition is imperative to avoid complications. We report the case of a 42-year-old female, known for a previous thymectomy for giant thymoma who has suffered for a long time from recurrent pulmonary and urinary tract infections and cold sores. In March 2016 she referred to our unit complaining of fever, cough, chest pain, and cold sores due to Herpes simplex virus (HSV), confirmed serologically as HSV-1. Chest X-ray showed left pneumonia due to Streptococcus pneumoniae. She started antibiotics (amoxicillin/clavulanic acid associated with azithromycin) with gradual improvement. Given her history she was studied for an underlying immunodeficiency: IgG, IgA, and IgM were significantly low or absent, as well as all IgG subclasses; blood and bone marrow aspirate leucocyte immunophenotyping showed complete absence of B lymphocytes and reduced CD4+ T cells. In light of: i) thymoma; ii) B lymphocyte deficit; iii) hypogammaglobulinemia; iv) recurrent infections, GS was diagnosed and pre-emptive immunoglobulin treatment, associated with HSV and Pneumocystis jiroveci prophylaxis (Acyclovir for HSV and Sulfamethoxazole- Trimethoprim for P. jiroveci) were started. Since then the patient has no longer presented any infectious episodes.
Keywords: immunodeficiency; thymomas; Good’s syndrome; hypogammaglobulinemia; infections immunodeficiency; thymomas; Good’s syndrome; hypogammaglobulinemia; infections

Share and Cite

MDPI and ACS Style

Tamburello, A.; Castelnovo, L.; Faggioli, P.; Bompane, D.; Brando, B.; Gatti, A.; Roncoroni, L.; Di Marco, B.; Mazzone, A. Good’s Syndrome, a Rare form of Acquired Immunodeficiency Associated with Thymomas. Clin. Pract. 2019, 9, 1112. https://doi.org/10.4081/cp.2019.1112

AMA Style

Tamburello A, Castelnovo L, Faggioli P, Bompane D, Brando B, Gatti A, Roncoroni L, Di Marco B, Mazzone A. Good’s Syndrome, a Rare form of Acquired Immunodeficiency Associated with Thymomas. Clinics and Practice. 2019; 9(2):1112. https://doi.org/10.4081/cp.2019.1112

Chicago/Turabian Style

Tamburello, Antonio, Laura Castelnovo, Paola Faggioli, Daniela Bompane, Bruno Brando, Arianna Gatti, Lucia Roncoroni, Biancamaria Di Marco, and Antonino Mazzone. 2019. "Good’s Syndrome, a Rare form of Acquired Immunodeficiency Associated with Thymomas" Clinics and Practice 9, no. 2: 1112. https://doi.org/10.4081/cp.2019.1112

APA Style

Tamburello, A., Castelnovo, L., Faggioli, P., Bompane, D., Brando, B., Gatti, A., Roncoroni, L., Di Marco, B., & Mazzone, A. (2019). Good’s Syndrome, a Rare form of Acquired Immunodeficiency Associated with Thymomas. Clinics and Practice, 9(2), 1112. https://doi.org/10.4081/cp.2019.1112

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