title: Immunological disturbances in Good's syndrome.
abstract: BACKGROUND
  Immunodeficiency with a thymoma (Good's syndrome) is a rare condition occurring in patients with adult-onset hypogammaglobulinaemia.
  
  
  METHODS
  We describe the case of a 38-yr-old woman with an upper mediastinal mass and inflammatory infiltrations in the lungs. After thymectomy, the patient's condition did not improve. The HRCT scan showed bronchiectasies with parenchymal opacities. As pulmonary infection persisted despite wide spectrum antibiotic therapy, additional tests were performed to diagnose an immunodeficiency. Serum immunoglobulin levels were very low. T cell response to mitogens was normal, but to Staphylococcus aureus Cowan I was impaired. Immunophenotyping of peripheral blood and bone marrow aspirate showed a very low number of B-cell at all the stages of development (CD10+CD19+, CD5+CD20). In peripheral blood 2.5% of CD19+ lymphocytes were found. On the basis of clinical history and immunological analysis, Good's syndrome was recognized. Treatment with intravenous gammaglobulin and antibiotics improved the patient's performance.
  
  
  CONCLUSIONS
  Measurement of serum immunoglobulin concentration is recommended for all patients suspected of thymoma.
authors.affiliation: Institute of Tuberculosis and Lung Diseases, Warsaw, Poland.
authors.forename: Justyna
authors.initials: J
authors.lastname: Fijolek
authors.forename: Elzbieta
authors.initials: E
authors.lastname: Wiatr
authors.forename: Urszula
authors.initials: U
authors.lastname: Demkow
authors.forename: Tadeusz Maria
authors.initials: TM
authors.lastname: Orlowsk
mesh_terms: D000328:Adult; D000361:Agammaglobulinemia / Q000097:blood / Q000150:complications / Q000276:immunology; D001402:B-Lymphocytes / Q000276:immunology; D005260:Female; D006801:Humans; D007136:Immunoglobulins / Q000097:blood; D007153:Immunologic Deficiency Syndromes / Q000097:blood / Q000150:complications* / Q000276:immunology*; D016130:Immunophenotyping; D013945:Thymoma / Q000097:blood / Q000150:complications* / Q000276:immunology*
chemical_list: D007136:Immunoglobulins