Faculdade de Ciências Médicas, Universidade de Campinas-Unicamp, Rua Tessália Vieira de Camargo 126, Cidade Universitária "Zeferino Vaz", 13083-887 Campinas, Brazil.
World J Gastroenterol. 2012 May 21;18(19):2430-3. doi: 10.3748/wjg.v18.i19.2430.
The case of a 52-year-old woman with a past history of thymoma resection who presented with chronic diarrhea and generalized edema is the focal point of this article. A diagnosis of Giardia lamblia infection was established, which was complicated by protein-losing enteropathy and severely low serum protein level in a patient with no urinary protein loss and normal liver function. After anti-helmintic treatment, there was recovery from hypoalbuminemia, though immunoglobulins persisted at low serum levels leading to the hypothesis of an immune system disorder. Good's syndrome is a rare cause of immunodeficiency characterized by the association of hypogammaglobulinemia and thymoma. This primary immune disorder may be complicated by severe infectious diarrhea secondary to disabled humoral and cellular immune response. This is the first description in the literature of an adult patient with an immunodeficiency syndrome who presented with protein-losing enteropathy secondary to giardiasis.
本文聚焦于一位 52 岁女性患者,她曾因胸腺瘤切除而就诊,现患有慢性腹泻和全身性水肿。该患者诊断为蓝氏贾第鞭毛虫感染,伴有蛋白丢失性肠病和严重低血清蛋白水平,但无蛋白尿和正常肝功能。在进行驱虫治疗后,低白蛋白血症得到了恢复,尽管免疫球蛋白仍处于低血清水平,这导致了免疫系统紊乱的假设。Good 综合征是一种罕见的免疫缺陷病,其特征是低丙种球蛋白血症和胸腺瘤的关联。这种原发性免疫紊乱可能会因体液和细胞免疫应答功能障碍而导致严重的传染性腹泻。这是文献中首次描述的成人免疫缺陷综合征患者,其因贾第虫病而发生蛋白丢失性肠病。