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Tuberculosis Meningoencephalomyelitis in Good's Syndrome: a Case Report

Brain & NeuroRehabilitation 2020년 13권 3호 p.16 ~ 16
권남우, 김형섭,
소속 상세정보
권남우 ( Kwon Nam-Woo ) - National Health Insurance Service Ilsan Hospital Department of Physical Medicine and Rehabilitation
김형섭 ( Kim Hyoung-Seop ) - National Health Insurance Service Ilsan Hospital Department of Physical Medicine and Rehabilitation

Abstract


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.

키워드

Tuberculosis Meningitis; Thymoma; Myasthenia Gravis; Immunologic Deficiency Syndromes; Rehabilitation

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