Journal
IMMUNOLOGY LETTERS
Volume 231, Issue -, Pages 11-17Publisher
ELSEVIER
DOI: 10.1016/j.imlet.2020.12.010
Keywords
Good syndrome; Thymoma; Hypogammglobulinemia; Immunodeficiency; Recurrent infection; Autoimmunity; Paraneoplastic syndromes
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Good Syndrome is a rare disease associated with thymoma and immunodeficiency, with an unclear prognosis. Understanding the relationship between clinical presentation and immunological changes is crucial for preventing misdiagnosis and complications.
Good Syndrome is a rare clinical entity first described as the conjunction of thymoma and hypogammaglobulinemia, and more recently depicted as a complex disease integrating a medical history of thymoma with humoral immunodeficiency (more accurately stated: hypogammaglobulinemia) with or without cellular immunodeficiency, recurrent infections, autoimmunity, paraneoplastic syndromes and diverse aberrations in the immunological profile. This condition has an ominous prognosis with a high mortality rate secondary to recalcitrant infectious diseases. Understanding the possible discordances in clinical presentation and the temporal relationship between manifestations and immunological alterations is key to prevent misdiagnosis and complications. To this end, here we provide two illustrative patients with Good Syndrome that share common clinical manifestations and yet show unique and opposed immunological profiles, thereby highlighting the pivotal interest of a comprehensive immunological profiling in these patients. We conducted a thorough review of existing literature on the elusive molecular mechanisms underlying the syndrome and provide a clinical assessment algorithm to facilitate the management of these challenging patients.
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