{"title":"Missed and misdiagnosis of immunodeficiency: Good syndrome presenting as persistent COVID-19 shedding.","authors":"Valerie Chiang, Tiffany C H So, Philip H Li","doi":"10.5415/apallergy.0000000000000171","DOIUrl":null,"url":null,"abstract":"<p><p>A 61-year-old man was referred to the immunology clinic due to prolonged COVID-19 infection and absent severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibodies. His infection, confirmed by polymerase chain reaction (PCR) testing upon returning to Hong Kong from Vancouver, resulted in a 31-day hospitalization due to persistent positive PCR results, despite his remaining asymptomatic. Laboratory tests revealed lymphopenia, low immunoglobulin levels, and unremarkable serum protein electrophoresis, with all viral serologies, including HIV, being negative. Although he received 3 doses of the Pfizer BioNTech vaccine, he showed no detectable SARS-CoV-2 antibodies. Further evaluation indicated almost-absent CD19 cells and low CD4 and CD8 counts, and coupled with his history of thymoma, this led to a diagnosis of Good syndrome. The patient began subcutaneous immunoglobulin replacement therapy and was started on long-term valganciclovir for moderate cytomegalovirus antigenemia.</p>","PeriodicalId":8488,"journal":{"name":"Asia Pacific Allergy","volume":"15 3","pages":"235-237"},"PeriodicalIF":2.1000,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12419395/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Asia Pacific Allergy","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.5415/apallergy.0000000000000171","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/8 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"ALLERGY","Score":null,"Total":0}
引用次数: 0
Abstract
A 61-year-old man was referred to the immunology clinic due to prolonged COVID-19 infection and absent severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibodies. His infection, confirmed by polymerase chain reaction (PCR) testing upon returning to Hong Kong from Vancouver, resulted in a 31-day hospitalization due to persistent positive PCR results, despite his remaining asymptomatic. Laboratory tests revealed lymphopenia, low immunoglobulin levels, and unremarkable serum protein electrophoresis, with all viral serologies, including HIV, being negative. Although he received 3 doses of the Pfizer BioNTech vaccine, he showed no detectable SARS-CoV-2 antibodies. Further evaluation indicated almost-absent CD19 cells and low CD4 and CD8 counts, and coupled with his history of thymoma, this led to a diagnosis of Good syndrome. The patient began subcutaneous immunoglobulin replacement therapy and was started on long-term valganciclovir for moderate cytomegalovirus antigenemia.
期刊介绍：
Asia Pacific Allergy (AP Allergy) is the official journal of the Asia Pacific Association of Allergy, Asthma and Clinical Immunology (APAAACI). Although the primary aim of the journal is to promote communication between Asia Pacific scientists who are interested in allergy, asthma, and clinical immunology including immunodeficiency, the journal is intended to be available worldwide. To enable scientists and clinicians from emerging societies appreciate the scope and intent of the journal, early issues will contain more educational review material. For better communication and understanding, it will include rational concepts related to the diagnosis and management of asthma and other immunological conditions. Over time, the journal will increase the number of original research papers to become the foremost citation journal for allergy and clinical immunology information of the Asia Pacific in the future.
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