A case report of acquired hypogammaglobulinemia with thymoma (Good syndrome)

We reported a case of acquired hypogammaglobulinemia with thymoma (Good syndrome). The case is a 67 year-old female, who has suffered from recourent infections such as flu, diarrhea, and pneumonia, since 1985. In Feb. 1989, she was diagnosed as having oral candidiasis. At that time, hypogammaglobulinemia and thymoma were also pointed out. Immunologic studies revealed marked decrease of circulating B cells and relative increase of T cells. The low ratio of CD 4⁺ cells/CD 8⁺ cells was also noted. T cells obtained from the patient possess inappropriate suppressor activity against immunoglobulin (IgG) production in cell-mixing experiments carried out in a PWM-driven immunoglobulin (IgG) assay system. These findings may explain the cause of hypogammaglobulinemia in this case. Thymectomy was performed in Jan. 1990. However, increase in the level of immunoglobulin is not apparent by the time of this report.