Numakura Tadahisa, Matsuura Yoshifumi, Takiguchi Hiroto, Hara Yasuka, Ameku Kouken
Ohta General Hospital Fundation, Ohta Nishinouchi Hospital, Center of Respiratory Disorders.
Nihon Kokyuki Gakkai Zasshi. 2011 Sep;49(9):647-50.
A 78-year-old woman was admitted because of persistent cough, fever and sputum for one week. She had been treated with radiation therapy for inoperable thymoma complicated by severe heart failure and had been suffering from recurrent pneumonia and otitis media since then. A chest radiograph on admission showed an anterior mediastinal mass shadow and infiltrates in the bilateral lower lung fields. Serum gamma globulin was decreased and erythroid cells in the bone marrow were markedly decreased. Thymoma with hypogammaglobulinemia is called Good syndrome. We reported this very rare case of Good syndrome. After improving the infection, cyclosporine A was administered for PRCA and hypo-gamma globulinemia, but we discontinued this due to liver dysfunction. We have been currently continuing her treatment with red blood cell transfusion and immunoglobulin supplement only.
一名78岁女性因持续咳嗽、发热和咳痰1周入院。她曾因无法手术的胸腺瘤合并严重心力衰竭接受放射治疗,此后一直患有复发性肺炎和中耳炎。入院时胸部X线片显示前纵隔肿块阴影及双侧下肺野浸润。血清γ球蛋白降低,骨髓红系细胞明显减少。伴有低丙种球蛋白血症的胸腺瘤称为古德综合征。我们报告了这例非常罕见的古德综合征病例。感染改善后,给予环孢素A治疗纯红细胞再生障碍性贫血和低丙种球蛋白血症,但因肝功能障碍而停药。目前我们仅继续给予她红细胞输血和补充免疫球蛋白进行治疗。