Recurrent neutropenia and chronic diarrhea following thymectomy: the good, the bad, and the ugly. Issue 2 (4th March 2021)

• Record Type: Journal Article
• Authors: Oyenuga, Mosunmoluwa; Shaikh, Safia; Harris, Benjamin; Sinha, Jyotsana; Lacasse, Alexandre
• Is Part Of: Journal of community hospital internal medicine perspectives. Volume 11:Issue 2(2021)
• Page Start: 263
• Page End: 265
• Publication Date: 2021-03-04
• Subjects: Good syndrome -- thymoma -- thymectomy -- hypogammaglobulinemia -- pure white cell aplasia -- neutropenia -- immunodeficiency -- chronic diarrhea; Internal medicine -- Periodicals; Hospitals -- Periodicals; Hospitals, Community; Internal Medicine; Hospitals; Internal medicine; Periodicals; Periodicals; 610
• DOI: 10.1080/20009666.2021.1877400
• Languages: English
• ISSNs: 2000-9666

Abstract

ABSTRACT: Good syndrome (GS) is a rare paraneoplastic syndrome seen before or after diagnosis of thymoma, and its treatment, and is characterized by hypogammaglobulinemia. Rarely, pure white cell aplasia (PWCA) can also be seen which can present as recurrent neutropenia. We describe a 64-year-old man with recurrent sinus infections and previous thymectomy for stage 1 type B2 thymoma presenting with chronic diarrhea and recurrent neutropenia necessitating serial hospitalizations despite repeated antimicrobial treatment. Immunoglobulin levels, including IgM, IgA, IgD, and IgE were undetectable. Flow cytometry also showed absent B cells. Patient was initiated on immunoglobulin replacement therapy with consequent significant clinical improvement. Despite thymectomy, patients can develop thymoma-associated paraneoplastic syndromes, including GS.