Good's syndrome in a patient with cytomegalovirus retinitis

David SP Yong, MK Tsang, Eric YT Chan, Doris MW Tse
Department of Medicine and Geriatrics, Caritas Medical Centre, Shamshuipo, Kowloon, Hong Kong

Thymoma-related adult-onset immunodeficiency or Good's syndrome is an uncommon condition. This case, of a 50-year-old woman who was human immunodeficiency virus– negative and developed herpes zoster and severe cytomegalovirus retinitis 6 months after removal of a thymoma, is the first to be reported in Hong Kong. Immunological investigations revealed no B cells, hypogammaglobulinaemia, a low CD4 count, and a low CD4/CD8 ratio. We recommend that immunological investigations, including T-cell subsets, B cells, and quantitative immunoglobulins, should be part of the routine diagnostic evaluation of patients with thymoma and infections.

Hong Kong Med J 2008;14:142-4

Key words: Agammaglobulinemia; Cytomegalovirus retinitis; immunologic deficiency syndromes; Opportunistic infections; Thymoma