Immunodeficiency associated with tumour pathology: Good's syndrome

BMJ Case Rep. 2019 Mar 20;12(3):e227970. doi: 10.1136/bcr-2018-227970.

Abstract

The Good's syndrome (GS) is a low prevalence entity where thymoma often is associated with immunodeficiency. Patients may start presenting recurrent rhinosinusal infections, bronchopulmonary infections, haematological alterations and diarrhoea, secondary to immunodeficiency. They can also present respiratory symptoms and parathymic syndromes derived from the existence of thymoma, a slow-growing neoplasm located in the anterior mediastinum. We present the case of a 76-year-old man diagnosed with thymoma by image analysis, which had presented multiple episodes of pneumonia and two admissions to the hospital for diarrhoea of weeks of evolution. After finishing the study, the patient is diagnosed of GS. In this case, thymectomy prevented the appearance of parathymic syndrome, but without any effect on immunodeficiency symptoms. To decrease repeat infections, substitution therapy with immunoglobulins was started. The prognosis will depend mainly on the recurrent infectious and to a lesser extent on the thymic neoplasm.

Keywords: immunology; malignant disease and immunosuppression; oncology.

Publication types

  • Case Reports

MeSH terms

  • Administration, Intravenous
  • Aged
  • Humans
  • Immunoglobulin G / administration & dosage
  • Immunologic Deficiency Syndromes / complications*
  • Immunologic Deficiency Syndromes / drug therapy
  • Immunologic Factors / administration & dosage
  • Male
  • Thymoma / etiology*
  • Thymoma / pathology
  • Thymus Neoplasms / etiology*
  • Thymus Neoplasms / pathology

Substances

  • Immunoglobulin G
  • Immunologic Factors