title: Good's syndrome and pure white cell aplasia complicated by cryptococcus infection: A case report and review of the literature.
abstract: Thymomas can present with a variety of paraneoplastic manifestations, mostly of autoimmune origin, including Good's syndrome when there is associated hypogammaglobulinemia. Although pure red cell aplasia is a recognised complication of thymoma, selective white cell aplasia is very rare, particularly in Good's syndrome. Lethal opportunistic infections are a feature of Good's syndrome, usually occurring in those patients with associated severe T lymphocyte defects. Although the cryptococcus is a recognised fungal pathogen in patients with other causes of CD4+ T cell lymphopenia, surprisingly this complication has not been reported in patients with Good's syndrome. We now describe a 70 year old man with Good's syndrome and pure white cell aplasia who presented with disseminated cryptococcosis, and provide an up-to-date review of the relevant literature. Despite meningeal involvement our patient recovered after combined treatment with intravenous globulin, granulocyte stimulating growth, corticosteroids and antifungal therapy.
authors.affiliation: Department of Internal Medicine, 5th floor, University General Hospital of Patras, 26504, Rio, Greece, akin@upatras.gr.
authors.forename: K
authors.initials: K
authors.lastname: Akinosoglou
authors.forename: M
authors.initials: M
authors.lastname: Melachrinou
authors.forename: D
authors.initials: D
authors.lastname: Siagris
authors.forename: E
authors.initials: E
authors.lastname: Koletsis
authors.forename: M
authors.initials: M
authors.lastname: Marangos
authors.forename: C A
authors.initials: CA
authors.lastname: Gogos
authors.forename: E E
authors.initials: EE
authors.lastname: Solomou
mesh_terms: D000368:Aged; D001706:Biopsy; D001853:Bone Marrow / Q000473:pathology; D003453:Cryptococcosis / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D005260:Female; D006801:Humans; D007970:Leukopenia / Q000175:diagnosis / Q000209:etiology*; D013945:Thymoma / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D013953:Thymus Neoplasms / Q000150:complications* / Q000175:diagnosis / Q000601:surgery