{"title":"古德氏综合征患者接受免疫球蛋白替代疗法后，持续性 COVID-19 病症得到改善","authors":"Ikumi Kashiwagi , Miki Tasato , Akihiko Sokai , Wataru Kishimoto , Toshiyuki Iwata , Yasuyuki Hayashi , Yuki Sakai , Naoaki Yasuda , Takashi Nishimura","doi":"10.1016/j.resinv.2024.11.009","DOIUrl":null,"url":null,"abstract":"<div><div>A 69-year-old man with a history of thymoma resection was diagnosed with COVID-19 pneumonia. Initially, the patient responded well to molnupiravir, but he experienced a relapse. Subsequent steroids for COVID-19-related organizing pneumonia (OP) led to temporary improvement, but his condition deteriorated when the steroids were tapered off. Further investigation revealed hypogammaglobulinemia, and Good's syndrome (GS) was diagnosed. Immunoglobulin replacement therapy was administered, significantly improving the pulmonary shadows, and no subsequent relapse occurred. GS is an immunodeficiency condition associated with thymoma. If COVID-19 recurs or is refractory despite steroid therapy for OP, COVID-19 itself may not be resolved due to immunodeficiency.</div></div>","PeriodicalId":20934,"journal":{"name":"Respiratory investigation","volume":"63 1","pages":"Pages 7-9"},"PeriodicalIF":2.4000,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Persistent COVID-19 improved with immunoglobulin replacement therapy in Good's syndrome\",\"authors\":\"Ikumi Kashiwagi , Miki Tasato , Akihiko Sokai , Wataru Kishimoto , Toshiyuki Iwata , Yasuyuki Hayashi , Yuki Sakai , Naoaki Yasuda , Takashi Nishimura\",\"doi\":\"10.1016/j.resinv.2024.11.009\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><div>A 69-year-old man with a history of thymoma resection was diagnosed with COVID-19 pneumonia. Initially, the patient responded well to molnupiravir, but he experienced a relapse. Subsequent steroids for COVID-19-related organizing pneumonia (OP) led to temporary improvement, but his condition deteriorated when the steroids were tapered off. Further investigation revealed hypogammaglobulinemia, and Good's syndrome (GS) was diagnosed. Immunoglobulin replacement therapy was administered, significantly improving the pulmonary shadows, and no subsequent relapse occurred. GS is an immunodeficiency condition associated with thymoma. If COVID-19 recurs or is refractory despite steroid therapy for OP, COVID-19 itself may not be resolved due to immunodeficiency.</div></div>\",\"PeriodicalId\":20934,\"journal\":{\"name\":\"Respiratory investigation\",\"volume\":\"63 1\",\"pages\":\"Pages 7-9\"},\"PeriodicalIF\":2.4000,\"publicationDate\":\"2024-11-25\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Respiratory investigation\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S2212534524001783\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"RESPIRATORY SYSTEM\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Respiratory investigation","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2212534524001783","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"RESPIRATORY SYSTEM","Score":null,"Total":0}
引用次数: 0
摘要
一名曾做过胸腺瘤切除术的 69 岁男子被诊断出患有 COVID-19 肺炎。起初，患者对莫仑匹韦反应良好，但后来病情复发。随后，他因COVID-19相关的组织性肺炎（OP）而接受类固醇治疗，结果病情暂时好转，但类固醇用量减少后病情恶化。进一步检查发现他患有低丙种球蛋白血症，并确诊为古德综合征（GS）。他接受了免疫球蛋白替代疗法，肺部阴影明显改善，之后也没有复发。GS是一种与胸腺瘤相关的免疫缺陷病。如果 COVID-19 复发或在类固醇治疗 OP 后仍难治，COVID-19 本身可能因免疫缺陷而无法治愈。
Persistent COVID-19 improved with immunoglobulin replacement therapy in Good's syndrome
A 69-year-old man with a history of thymoma resection was diagnosed with COVID-19 pneumonia. Initially, the patient responded well to molnupiravir, but he experienced a relapse. Subsequent steroids for COVID-19-related organizing pneumonia (OP) led to temporary improvement, but his condition deteriorated when the steroids were tapered off. Further investigation revealed hypogammaglobulinemia, and Good's syndrome (GS) was diagnosed. Immunoglobulin replacement therapy was administered, significantly improving the pulmonary shadows, and no subsequent relapse occurred. GS is an immunodeficiency condition associated with thymoma. If COVID-19 recurs or is refractory despite steroid therapy for OP, COVID-19 itself may not be resolved due to immunodeficiency.
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