Good综合征合并新型冠状病毒持续感染、肺腺癌一例并文献复习_Chinese Journal of Respiratory and Critical Care Medicine

Authors：

樊俊玲 ,  陈亚娟

重庆医科大学附属第一医院呼吸与危重症医学科（重庆 400016）;

Corresponding author：

陈亚娟, Email: yajuanchencqmu@sina.com

Keywords：

Good综合征; 新型冠状病毒感染; 肺腺癌

DOI：

10.7507/1671-6205.202406128

Video：

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目的通过本病例及文献复习以增加对Good综合征合并新型冠状病毒感染（coronavirus disease 2019，COVID-19）及免疫缺陷与肿瘤发生的认知，为Good综合征合并COVID-19的治疗提供参考。方法回顾我院诊治的1例Good综合征合并新型冠状病毒（新冠病毒）持续感染、肺腺癌患者的临床资料，复习既往Good综合征合并COVID-19相关文献，总结其临床特征及治疗方法。结果患者男，61岁，反复发热、咳嗽6个月余。胸部CT提示双肺多发炎症，右肺上叶前段胸膜下混合磨玻璃结节，前纵隔肿块；新冠病毒核酸检测阳性，新冠病毒IgG+IgM抗体检测阴性。给予康复期血浆疗法后患者明显好转，核酸检测呈阴性，抗体检测呈阳性，后于我院手术切除纵隔及肺部病变，最终明确诊断为Good综合征合并浸润性肺腺癌。复习文献，共有17例Good综合征合并COVID-19个案报道，男性相较于女性发病率更高，胸腺瘤主要病理类型为AB型（55.6%），大部分患者给予了免疫球蛋白治疗，但仍有7例患者死亡，死亡原因大多为呼吸衰竭、脓毒性休克。结论对于有胸腺瘤病史伴反复感染的患者临床医生应想到Good综合征的可能，早诊断早治疗，同时对存在免疫缺陷、胸腺瘤的患者要警惕恶性肿瘤的发生。

Citation： 樊俊玲, 陈亚娟. Good综合征合并新型冠状病毒持续感染、肺腺癌一例并文献复习. Chinese Journal of Respiratory and Critical Care Medicine, 2025, 24(3): 197-201. doi: 10.7507/1671-6205.202406128 Copy

1.	Tavakol M, Mahdaviani SA, Ghaemi MR, et al. Good’s syndrome-association of the late onset combined immunodeficiency with thymoma: review of literature and case report. Iran J Allergy Asthma Immunol, 2018, 17(1): 85-93.
2.	Yang C, Zhao H, Espín E, et al. Association of SARS-CoV-2 infection and persistence with long COVID. Lancet Respir Med, 2023, 11(6): 504-506.
3.	Pozzi MR, Baronio M, Janetti MB, et al. Fatal SARS-CoV-2 infection in a male patient with Good’s syndrome. Clin Immunol, 2021, 223: 108644.
4.	London J, Boutboul D, Lacombe K, et al. Severe COVID-19 in patients with B cell alymphocytosis and response to convalescent plasma therapy. J Clin Immunol, 2021, 41(2): 356-361.
5.	López AL, Torre MG, Paolini MV, et al. COVID-19 in adults with antibody deficiencies. Medicina (B Aires), 2021, 81(3): 478-481.
6.	Cosesquius ML, Lópezmontesinos I, Gimenomartinez R, et al. Severe COVID-19 pneumonia in Good syndrome with a favorable outcome. Clin Immunol, 2022, 235: 108789.
7.	Duarte M, Faria L, Patronillo C, et al. A case of severe COVID-19 in a patient with Good’s syndrome. Eur J Case Rep Intern Med, 2021, 8(10): 002976.
8.	Lindahl H, Smith CIE, Bergman P. COVID-19 in a patient with Good’s syndrome and in 13 patients with common variable immunodeficiency. Clin Immunol Commun, 2021, 1: 20-24.
9.	Meena M, Kumar KS, Rajawat GS, et al. Five times reactivation of COVID-19 in a patient with thymoma. J Assoc Physicians India, 2022, Feb,70(2): 11-12.
10.	Maldonado-domínguez ED, Farrill-romanillos PM. Patient with Good’s syndrome and COVID-19: report of a clinical case. Rev Med Inst Mex Seguro Soc, 2022, 60(4): 474-479.
11.	Wee LE, Tan JY, Oon LLE, et al. Relapsing COVID-19 infection as a manifestation of Good syndrome: a case report and literature review. Int J Infect Dis, 2023, 129: 236-239.
12.	Berzenji L, Yogeswaran SK, Snoeckx A, et al. Good’s syndrome and COVID-19: case report and literature review. Mediastinum, 2023, 7: 5.
13.	Cerezoli MT, Prats JAGG, Medeiros AK, et al. Clinical and radiological improvement of protracted COVID-19 and Good syndrome secondary to advanced thymoma. Pulmonology, 2022, 28(6): 472-475.
14.	杨露露, 黄丽婷, 任思颖, 等. Good综合征合并新型冠状病毒感染4例并文献复习. 中华结核和呼吸杂志, 2024, 47(5): 430-436. DOI: 10.3760/cma.j.cn112147-20230923 -00192.
15.	Tabarsi P, Hemmatian M, Moradi M. Long COVID‐19 leading to Good’s syndrome diagnosis: a clinical case‐report and literature review. Clin Case Rep, 2024, 12(6): e8962.
16.	Guevara-hoyer K, Fuentes-antrás J, Calatayudgastardi J, et al. Immunodeficiency and thymoma in Good syndrome: two sides of the same coin. Immunol Lett, 2021, 231: 11-17.
17.	Chen YD, Wen ZH, Wei B, et al. Clinicopathologic features of Good’s syndrome: two cases and literature review. Open Med (Wars), 2021, 16(1): 532-539.
18.	Wang CH, Chan ED, Perng CL, et al. Intravenous immunoglobulin replacement therapy to prevent pulmonary infection in a patient with Good’s syndrome. J Microbiol Immunol Infect, 2015, 48(2): 229-232.
19.	Schumacher TN, Schreiber RD. Neoantigens in cancer immunotherapy. Science, 2015, 348(6230): 69-74.
20.	Oskara H. Immunodeficiency and cancer predisposition revisited: embedding two closely related concepts into an integrative conceptual framework. Frontiers in immunology, 2019, 9.
21.	Eilber FR, Morton DL. Impaired immunologic reactivity and recurrence following cancer surgery. Cancer. 1970, 25(2): 362-367.
22.	Mayor PC, Eng KH, Singel KL, et al. Cancer in primary immunodeficiency diseases: cancer incidence in the United States Immune Deficiency Network Registry. J Allergy Clin Immunol, 2018, 141(3): 1028-1035.
23.	杨宁宁, 刘绍霞. AB型胸腺瘤合并肺腺癌1例. 临床肿瘤学杂志, 2016, 21(4): 381-382.
24.	Patella M, Anile M, Vitolo D, et al. Synchronous B3 thymoma and lung bronchoalveolar carcinoma. Interact Cardiovasc Thorac Surg, 2011, 12(1): 75-76.

1. Tavakol M, Mahdaviani SA, Ghaemi MR, et al. Good’s syndrome-association of the late onset combined immunodeficiency with thymoma: review of literature and case report. Iran J Allergy Asthma Immunol, 2018, 17(1): 85-93.
2. Yang C, Zhao H, Espín E, et al. Association of SARS-CoV-2 infection and persistence with long COVID. Lancet Respir Med, 2023, 11(6): 504-506.
3. Pozzi MR, Baronio M, Janetti MB, et al. Fatal SARS-CoV-2 infection in a male patient with Good’s syndrome. Clin Immunol, 2021, 223: 108644.
4. London J, Boutboul D, Lacombe K, et al. Severe COVID-19 in patients with B cell alymphocytosis and response to convalescent plasma therapy. J Clin Immunol, 2021, 41(2): 356-361.
5. López AL, Torre MG, Paolini MV, et al. COVID-19 in adults with antibody deficiencies. Medicina (B Aires), 2021, 81(3): 478-481.
6. Cosesquius ML, Lópezmontesinos I, Gimenomartinez R, et al. Severe COVID-19 pneumonia in Good syndrome with a favorable outcome. Clin Immunol, 2022, 235: 108789.
7. Duarte M, Faria L, Patronillo C, et al. A case of severe COVID-19 in a patient with Good’s syndrome. Eur J Case Rep Intern Med, 2021, 8(10): 002976.
8. Lindahl H, Smith CIE, Bergman P. COVID-19 in a patient with Good’s syndrome and in 13 patients with common variable immunodeficiency. Clin Immunol Commun, 2021, 1: 20-24.
9. Meena M, Kumar KS, Rajawat GS, et al. Five times reactivation of COVID-19 in a patient with thymoma. J Assoc Physicians India, 2022, Feb,70(2): 11-12.
10. Maldonado-domínguez ED, Farrill-romanillos PM. Patient with Good’s syndrome and COVID-19: report of a clinical case. Rev Med Inst Mex Seguro Soc, 2022, 60(4): 474-479.
11. Wee LE, Tan JY, Oon LLE, et al. Relapsing COVID-19 infection as a manifestation of Good syndrome: a case report and literature review. Int J Infect Dis, 2023, 129: 236-239.
12. Berzenji L, Yogeswaran SK, Snoeckx A, et al. Good’s syndrome and COVID-19: case report and literature review. Mediastinum, 2023, 7: 5.
13. Cerezoli MT, Prats JAGG, Medeiros AK, et al. Clinical and radiological improvement of protracted COVID-19 and Good syndrome secondary to advanced thymoma. Pulmonology, 2022, 28(6): 472-475.
14. 杨露露, 黄丽婷, 任思颖, 等. Good综合征合并新型冠状病毒感染4例并文献复习. 中华结核和呼吸杂志, 2024, 47(5): 430-436. DOI: 10.3760/cma.j.cn112147-20230923 -00192.
15. Tabarsi P, Hemmatian M, Moradi M. Long COVID‐19 leading to Good’s syndrome diagnosis: a clinical case‐report and literature review. Clin Case Rep, 2024, 12(6): e8962.
16. Guevara-hoyer K, Fuentes-antrás J, Calatayudgastardi J, et al. Immunodeficiency and thymoma in Good syndrome: two sides of the same coin. Immunol Lett, 2021, 231: 11-17.
17. Chen YD, Wen ZH, Wei B, et al. Clinicopathologic features of Good’s syndrome: two cases and literature review. Open Med (Wars), 2021, 16(1): 532-539.
18. Wang CH, Chan ED, Perng CL, et al. Intravenous immunoglobulin replacement therapy to prevent pulmonary infection in a patient with Good’s syndrome. J Microbiol Immunol Infect, 2015, 48(2): 229-232.
19. Schumacher TN, Schreiber RD. Neoantigens in cancer immunotherapy. Science, 2015, 348(6230): 69-74.
20. Oskara H. Immunodeficiency and cancer predisposition revisited: embedding two closely related concepts into an integrative conceptual framework. Frontiers in immunology, 2019, 9.
21. Eilber FR, Morton DL. Impaired immunologic reactivity and recurrence following cancer surgery. Cancer. 1970, 25(2): 362-367.
22. Mayor PC, Eng KH, Singel KL, et al. Cancer in primary immunodeficiency diseases: cancer incidence in the United States Immune Deficiency Network Registry. J Allergy Clin Immunol, 2018, 141(3): 1028-1035.
23. 杨宁宁, 刘绍霞. AB型胸腺瘤合并肺腺癌1例. 临床肿瘤学杂志, 2016, 21(4): 381-382.
24. Patella M, Anile M, Vitolo D, et al. Synchronous B3 thymoma and lung bronchoalveolar carcinoma. Interact Cardiovasc Thorac Surg, 2011, 12(1): 75-76.

Chinese Journal of Respiratory and Critical Care Medicine

Good综合征合并新型冠状病毒持续感染、肺腺癌一例并文献复习

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