Opportunistic lung infections as a manifestation of Good's syndrome

Suk Yeon Kim; Joo-Hee Kim; Ha Won Hwang; Kwang Youn Kim; Sunghoon Park; Young Il Hwang; Seung Hun Jang; Ki-Suck Jung

doi:10.4168/aard.2015.3.5.365

Journal List > Allergy Asthma Respir Dis > v.3(5) > 1059131

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Kim, Kim, Hwang, Kim, Park, Hwang, Jang, and Jung: Opportunistic lung infections as a manifestation of Good's syndrome

Case Report

Allergy, Asthma & Respiratory Disease 2015; 3(5): 365-369.

Published online: 30 September 2015

DOI: https://doi.org/10.4168/aard.2015.3.5.365

Opportunistic lung infections as a manifestation of Good's syndrome

Suk Yeon Kim, Joo-Hee Kim

, Ha Won Hwang, Kwang Youn Kim, Sunghoon Park, Young Il Hwang, Seung Hun Jang, Ki-Suck Jung

Department of Internal Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea.

Correspondence to: Joo-Hee Kim. Department of Internal Medicine, Hallym University Sacred Heart Hospital, 22 Gwanpyeong-ro 170beon-gil, Dongan-gu, Anyang 14068, Korea. Tel: +82-31-380-3972, Fax: +82-31-383-3768, luxjhee@gmail.com

Received 1 June 2015 Revised 26 July 2015 Accepted 29 July 2015

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/).

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.

Keywords: Good's syndrome, Thymoma, Hypogammaglobulinemia, Pneumonia, Opportunistic infections

Figures and Tables

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).

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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ORCID iDs: Joo-Hee Kim
https://orcid.org/http://orcid.org/0000-0002-1572-5149
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