KMID : 1202320200130030016
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Brain & NeuroRehabilitation 2020 Volume.13 No. 3 p.16 ~ p.16
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Tuberculosis Meningoencephalomyelitis in Good's Syndrome: a Case Report
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Kwon Nam-Woo
Kim Hyoung-Seop
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Abstract
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Good's syndrome is a rare disease characterized by thymoma associated with combined B- and T-cell immunodeficiency in adults. Due to the lack of early onset of symptoms, it is difficult to diagnose this disorder. A 44-year-old man diagnosed with thymic carcinoma was admitted to the hospital with quadriplegia for 6 months. Brain abscess and meningoencephalitis were identified in the magnetic resonance imaging (MRI) of the brain. Antibiotics, steroid, and intravenous immunoglobulin treatment were provided for 3 months. Follow-up MRI showed progression to C7-level. The radiologic findings were consistent with tuberculosis infection and thus, the patient was treated with anti-tuberculosis medication. MRI of the brain and spine showed an improved state of meningoencephalomyelitis. In a laboratory study, there were decreased levels of peripheral B-cell and CD4 T-cell and decreased CD4:CD8 ratio; therefore, it confirmed that cellular immunity deteriorated. In addition to clinical findings, we were able to diagnose the patient with Good's syndrome. Good's syndrome is a highly suspicious disease in patients with thymoma who have recurrent unusual infections. Immunologic tests should be performed for diagnosis in which it can prevent delayed diagnosis and allow timely treatment.
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KEYWORD
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Tuberculosis Meningitis, Thymoma, Myasthenia Gravis, Immunologic Deficiency Syndromes, Rehabilitation
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