Good’s syndrome with increasing γδ T-lymphocyte subpopulation: A case report
Introduction. Good’s syndrome is a rare cause of adultonset immunodeficiency associated with thymoma. Good’s syndrome should be considered in patients older than 40 years with the history of frequent infections. An abnormal immunoglobulin profile needs further investigation and flow cytomet...
Main Authors: | , , , |
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Format: | Article |
Language: | English |
Published: |
Military Health Department, Ministry of Defance, Serbia
2015-01-01
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Series: | Vojnosanitetski Pregled |
Subjects: | |
Online Access: | http://www.doiserbia.nb.rs/img/doi/0042-8450/2015/0042-84501500102T.pdf |
Summary: | Introduction. Good’s syndrome is a rare cause of adultonset immunodeficiency
associated with thymoma. Good’s syndrome should be considered in patients
older than 40 years with the history of frequent infections. An abnormal
immunoglobulin profile needs further investigation and flow cytometry which
is crucial for establishing the diagnosis of Good’s syndrome. Case report. We
present a 56- year-old men with Good’s syndrome diagnosed after a twoyear
history of recurrent infections. Examination of immune status of the patient
showed decreased serum levels of all immunoglobulins. Flow cytometry of
peripheral blood lymphocyte revealed markedly reduced peripheral B cells, CD4
T-cell lymphopenia, inverted CD4/CD8 T-cell-ratio 0.37 (CD4 - 20.82%, CD8 -
70.7%). Analysis of the subpopulations of T-lymphocytes showed relative
increasing γδ T cell receptor (TCR) T lymphocytes. Computed tomography scan
of the chest showed a mediastinal mass compatible with thymoma of the
diameter of 40 mm. After initiation of intravenous immunoglobulins the
patient was in the good clinical condition and without bacterial
complications. As the patient refused the operative treatment we continued to
control the mediastinal tumor mass which did not increase during a 3-year
follow-up. Conclusion. The presented patient had a typical immunological
finding for Good’s syndrome, but also the increase in γδ TCR T-lymphocyte
subpopulation for which it is difficult to determine whether this is
pathogenetic or secondary reactive event. |
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ISSN: | 0042-8450 2406-0720 |