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CASE REPORT
A case of Good’s syndrome complicated by erythema multiforme
  1. Laura R Glick1,
  2. William Wyatt Wilson2 and
  3. Michelle Fletcher3
  1. 1 Pritzker School of Medicine, University of Chicago, Chicago, Illinois, USA
  2. 2 Department of Medicine, University of Chicago, Chicago, Illinois, USA
  3. 3 Hospital Medicine, Northwestern Memorial Hospital, Chicago, Illinois, USA
  1. Correspondence to Dr Michelle Fletcher, Michelle.Fletcher{at}nm.org

Abstract

Good’s syndrome (GS) is a rare, adult-onset combined B cell and T cell immunodeficiency with an associated thymoma. These patients have an increased risk of bacterial, fungal, viral and opportunistic infections. This report describes a 75-year-old female patient who presented with a full body rash and an anterior mediastinal mass. She underwent a biopsy of her rash and mass, which revealed erythema multiforme and WHO Type A thymoma, respectively. During her hospitalisation, she was also found to have oropharyngeal candidiasis, methicillin-susceptible Staphylococcus aureus bacteraemia and herpes simplex virus type 2 (HSV-2) skin lesions. Based on the number of infections and severity of her rash, an immunocompromised state was suspected. Immunological testing revealed a B cell and T cell deficiency as well as low serum immunoglobulins. This combination of hypogammaglobulinaemia and thymoma led to a diagnosis of GS. While there have been many case reports of GS, this is the first report of the immunodeficiency presenting with erythema multiforme.

  • infectious diseases
  • immunology
  • dermatology
  • respiratory medicine
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Footnotes

  • Contributors LRG, WWW and MF contributed to the drafting of the manuscript, the revision of the manuscript and the approval of the final version of the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Patient consent for publication Obtained.

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