array:23 [
  "pii" => "S2173511511000790"
  "issn" => "21735115"
  "doi" => "10.1016/j.rppnen.2011.11.004"
  "estado" => "S300"
  "fechaPublicacion" => "2011-11-01"
  "aid" => "30"
  "copyrightAnyo" => "2011"
  "documento" => "article"
  "crossmark" => 0
  "licencia" => "http://www.elsevier.com/open-access/userlicense/1.0/"
  "subdocumento" => "sco"
  "cita" => "Rev Port Pneumol. 2011;17:272-4"
  "abierto" => array:3 [
    "ES" => true
    "ES2" => true
    "LATM" => true
  ]
  "gratuito" => true
  "lecturas" => array:2 [
    "total" => 3148
    "formatos" => array:3 [
      "EPUB" => 248
      "HTML" => 1739
      "PDF" => 1161
    ]
  ]
  "itemSiguiente" => array:18 [
    "pii" => "S2173511511000807"
    "issn" => "21735115"
    "doi" => "10.1016/j.rppnen.2011.11.005"
    "estado" => "S300"
    "fechaPublicacion" => "2011-11-01"
    "aid" => "29"
    "documento" => "article"
    "crossmark" => 0
    "licencia" => "http://www.elsevier.com/open-access/userlicense/1.0/"
    "subdocumento" => "sco"
    "cita" => "Rev Port Pneumol. 2011;17:275-7"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 2992
      "formatos" => array:3 [
        "EPUB" => 234
        "HTML" => 1695
        "PDF" => 1063
      ]
    ]
    "en" => array:11 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Case report</span>"
      "titulo" => "A massive pleural-based tumour&#58; The challenge of diagnosis"
      "tienePdf" => "en"
      "tieneTextoCompleto" => 0
      "tieneResumen" => array:2 [
        0 => "en"
        1 => "pt"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "275"
          "paginaFinal" => "277"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "pt" => array:1 [
          "titulo" => "Um tumor gigante de base pleural&#58; o desafio do diagn&#243;stico"
        ]
      ]
      "contieneResumen" => array:2 [
        "en" => true
        "pt" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "H&#46; Elsayed, J&#46; Gosney"
          "autores" => array:2 [
            0 => array:2 [
              "nombre" => "H&#46;"
              "apellidos" => "Elsayed"
            ]
            1 => array:2 [
              "nombre" => "J&#46;"
              "apellidos" => "Gosney"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173511511000807?idApp=UINPBA00004E"
    "url" => "/21735115/0000001700000006/v1_201305151553/S2173511511000807/v1_201305151553/en/main.assets"
  ]
  "itemAnterior" => array:19 [
    "pii" => "S2173511511000479"
    "issn" => "21735115"
    "doi" => "10.1016/j.rppnen.2011.10.002"
    "estado" => "S300"
    "fechaPublicacion" => "2011-11-01"
    "aid" => "37"
    "copyright" => "Sociedade Portuguesa de Pneumologia"
    "documento" => "article"
    "crossmark" => 0
    "licencia" => "http://www.elsevier.com/open-access/userlicense/1.0/"
    "subdocumento" => "fla"
    "cita" => "Rev Port Pneumol. 2011;17:266-71"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 4037
      "formatos" => array:3 [
        "EPUB" => 263
        "HTML" => 2654
        "PDF" => 1120
      ]
    ]
    "en" => array:13 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Original article</span>"
      "titulo" => "Tuberculosis unit&#58; study of 10 years of activity &#40;1999&#8211;2009&#41;"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "tieneResumen" => array:2 [
        0 => "en"
        1 => "pt"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "266"
          "paginaFinal" => "271"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "pt" => array:1 [
          "titulo" => "Unidade de Tuberculose&#58; casu&#237;stica de dez anos de actividade &#40;1999&#8211;2009&#41;"
        ]
      ]
      "contieneResumen" => array:2 [
        "en" => true
        "pt" => true
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 0
        "multimedia" => array:7 [
          "identificador" => "fig0010"
          "etiqueta" => "Figure 2"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr2.jpeg"
              "Alto" => 944
              "Ancho" => 1583
              "Tamanyo" => 51590
            ]
          ]
          "descripcion" => array:1 [
            "en" => "<p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">Average lenght of analysed according to sensitivity patterns and the respective levels of significance&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "T&#46; Lopes, C&#46; Gomes, N&#46; Diogo"
          "autores" => array:3 [
            0 => array:2 [
              "nombre" => "T&#46;"
              "apellidos" => "Lopes"
            ]
            1 => array:2 [
              "nombre" => "C&#46;"
              "apellidos" => "Gomes"
            ]
            2 => array:2 [
              "nombre" => "N&#46;"
              "apellidos" => "Diogo"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173511511000479?idApp=UINPBA00004E"
    "url" => "/21735115/0000001700000006/v1_201305151553/S2173511511000479/v1_201305151553/en/main.assets"
  ]
  "en" => array:13 [
    "idiomaDefecto" => true
    "cabecera" => "<span class="elsevierStyleTextfn">Case report</span>"
    "titulo" => "<span class="elsevierStyleItalic">Haemophilus influenzae</span> pneumonia and immunodeficiency in association with thymoma&#8211;A presentation of Good&#39;s Syndrome"
    "tieneTextoCompleto" => 0
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "272"
        "paginaFinal" => "274"
      ]
    ]
    "autores" => array:1 [
      0 => array:4 [
        "autoresLista" => "A&#46; Fahim, M&#46; Abuzakouk, S&#46;P&#46; Hart"
        "autores" => array:3 [
          0 => array:4 [
            "nombre" => "A&#46;"
            "apellidos" => "Fahim"
            "email" => array:1 [
              0 => "ahmedfahim&#64;doctors&#46;org&#46;uk"
            ]
            "referencia" => array:2 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
              1 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">¿</span>"
                "identificador" => "cor0005"
              ]
            ]
          ]
          1 => array:3 [
            "nombre" => "M&#46;"
            "apellidos" => "Abuzakouk"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff0010"
              ]
            ]
          ]
          2 => array:3 [
            "nombre" => "S&#46;P&#46;"
            "apellidos" => "Hart"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
        ]
        "afiliaciones" => array:2 [
          0 => array:3 [
            "entidad" => "Division of Cardiovascular and Respiratory Studies&#44; Castle Hill Hospital&#44; Castle Road&#44; Cottingham&#44; United Kingdom"
            "etiqueta" => "<span class="elsevierStyleSup">a</span>"
            "identificador" => "aff0005"
          ]
          1 => array:3 [
            "entidad" => "Department of Immunology&#44; Hull Royal Infirmary&#44; Anlaby Road&#44; Hull&#44; United Kingdom"
            "etiqueta" => "<span class="elsevierStyleSup">b</span>"
            "identificador" => "aff0010"
          ]
        ]
        "correspondencia" => array:1 [
          0 => array:3 [
            "identificador" => "cor0005"
            "etiqueta" => "&#8270;"
            "correspondencia" => "Corresponding author&#46;"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "pt" => array:1 [
        "titulo" => "Pneumonia por Haemophilus Influenzae e imunodefici&#234;ncia associadas a timoma&#8211;uma apresenta&#231;&#227;o da S&#237;ndrome de Good"
      ]
    ]
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "PalabrasClave" => array:2 [
      "en" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Keywords"
          "identificador" => "xpalclavsec161701"
          "palabras" => array:3 [
            0 => "Respiratory infections"
            1 => "Immunodeficiency"
            2 => "Thymoma"
          ]
        ]
      ]
      "pt" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Palavras chave"
          "identificador" => "xpalclavsec161702"
          "palabras" => array:3 [
            0 => "Infec&#231;&#245;es respirat&#243;rias"
            1 => "Imunodefici&#234;ncia"
            2 => "Timoma"
          ]
        ]
      ]
    ]
    "tieneResumen" => true
    "resumen" => array:2 [
      "en" => array:2 [
        "titulo" => "Abstract"
        "resumen" => "<span class="elsevierStyleSectionTitle">Introduction</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Good&#39;s Syndrome is a rare cause of immunodeficiency associated with thymoma&#46; Patients with this syndrome are prone to infections with encapsulated microorganisms&#46; The diagnosis may be delayed for a considerable time period even after the thymectomy&#46; Case presentation&#58; We describe the case of a 70-year-old woman with a background of thymec-tomy who presented with pneumonia and gram negative sepsis&#46; Haemophilus influenzae was found in blood cultures&#46; Moreover&#44; there was evidence of impaired B and T cell immunity con-sistent with Good&#39;s Syndrome&#46; She was commenced on immunoglobulin replacement following treatment of sepsis and remains well 18 months after the initial presentation&#46;</p> <span class="elsevierStyleSectionTitle">Conclusion</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">This case illustrates the importance of considering Good&#39;s Syndrome in the con-text of pneumonia and immunodeficiency associated with encapsulated organisms such as Haemophilus influenzae&#46; This clinical entity is associated with a significant mortality and should be considered as a cause of immunodeficiency even years after thymectomy&#46;</p>"
      ]
      "pt" => array:2 [
        "titulo" => "Resumo"
        "resumen" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Introdu&#231;&#227;o&#58; A S&#237;ndrome de Good &#233; uma causa rara da imunodefici&#234;ncia associada ao timoma&#46; Os pacientes com esta s&#237;ndrome s&#227;o propensos a infec&#231;&#245;es por microrganismos encapsulados&#46; O diagn&#243;stico pode ser atrasado por bastante tempo&#44; mesmo ap&#243;s a timectomia&#46; Apresenta&#231;&#227;o do Caso&#58; Descrevemos o caso de uma mulher de 70 anos com antecedentes de timectomia&#44; que apresentava pneumonia e sepsis por agente gram negativo&#46; O Haemophilus influenzae foi isolado em hemoculturas&#46; Al&#233;m disso&#44; evid&#234;ncia de altera&#231;&#245;es da imunidade celular B e T&#44; consistente com a S&#237;ndrome de Good&#46; A doente iniciou terap&#234;utica de substitui&#231;&#227;o com imunoglobulina seguida de tratamento da sepsis e continua bem 18 meses ap&#243;s a apresenta&#231;&#227;o inicial&#46; Conclus&#227;o&#58; Este caso ilustra a import&#226;ncia de considerar a S&#237;ndrome de Good no contexto da pneumonia e imunodefici&#234;ncia associadas a organismos encapsulados&#44; como Haemophilus influenzae&#46; Esta entidade cl&#237;nica est&#225; associada a uma mortalidade significativa e deve ser considerada como uma causa de imunodefici&#234;ncia mesmo anos depois da timectomia&#46;</p>"
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "References"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0005"
          "bibliografiaReferencia" => array:11 [
            0 => array:3 [
              "identificador" => "bib0005"
              "etiqueta" => "&#91;1&#93;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Agammaglobulinaemia&#8211;a provocative experiment of nature"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "R&#46;A&#46; Good"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Bull Univ Minnesota&#46;"
                        "fecha" => "1954"
                        "volumen" => "26"
                        "paginaInicial" => "1"
                        "paginaFinal" => "19"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0010"
              "etiqueta" => "&#91;2&#93;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Hypogammaglobulinemia with deficiency of pre-B cells"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "A&#46;R&#46; Hayward"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Lancet&#46;"
                        "fecha" => "1978"
                        "volumen" => "1"
                        "paginaInicial" => "1014"
                        "paginaFinal" => "1015"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/2565485"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0015"
              "etiqueta" => "&#91;3&#93;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Acquired basophil and eosinophil deficiency in a patient with hypogammaglobulinemia associated with thymoma"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "E&#46;B&#46; Mitchell"
                            1 => "T&#46;A&#46; Platts Mills"
                            2 => "R&#46;S&#46; Pereira"
                            3 => "V&#46; Malkovska"
                            4 => "A&#46;D&#46; Webster"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Clin Lab Haematol&#46;"
                        "fecha" => "1983"
                        "volumen" => "5"
                        "paginaInicial" => "253"
                        "paginaFinal" => "257"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/6228374"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0020"
              "etiqueta" => "&#91;4&#93;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Infections in patients with immunodeficiency with thymoma &#40;Good syndrome&#41; Report of 5 cases and review of the literature"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "P&#46;E&#46; Tarr"
                            1 => "M&#46;C&#46; Sneller"
                            2 => "L&#46;J&#46; Mechanic"
                            3 => "A&#46; Economides"
                            4 => "C&#46;M&#46; Eger"
                            5 => "W&#46; Strober"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Medicine&#46;"
                        "fecha" => "2001"
                        "volumen" => "80"
                        "paginaInicial" => "123"
                        "paginaFinal" => "133"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11307588"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib0025"
              "etiqueta" => "&#91;5&#93;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Thymoma associated with hypogam-maglobulinaemia and pure red cell aplasia"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "W&#46;D&#46; Murray"
                            1 => "J&#46;N&#46; Webb"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Am J Med&#46;"
                        "fecha" => "1966"
                        "volumen" => "41"
                        "paginaInicial" => "974"
                        "paginaFinal" => "980"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/5954458"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib0030"
              "etiqueta" => "&#91;6&#93;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "hypogammaglobulinaemia and pernicious anemia"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "D&#46;G&#46; Davila"
                            1 => "D&#46;H&#46; Ryan"
                            2 => "Thymoma"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "South Med J&#46;"
                        "fecha" => "1986"
                        "volumen" => "79"
                        "paginaInicial" => "904"
                        "paginaFinal" => "906"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/3726592"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib0035"
              "etiqueta" => "&#91;7&#93;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Hypogammaglobulinaemia with thymoma&#44; haemolytic anemia&#44; and disseminated infection with cytomegalovirus"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "E&#46;S&#46; Mongan"
                            1 => "W&#46;A&#46; Kern Jr&#46;"
                            2 => "R&#46; Terry"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Ann Intern Med&#46;"
                        "fecha" => "1966"
                        "volumen" => "65"
                        "paginaInicial" => "548"
                        "paginaFinal" => "554"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/4287865"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib0040"
              "etiqueta" => "&#91;8&#93;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Limitin&#58; an interferon-like cytokine that preferentially influences B lymphocyte precursors"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "K&#46; Oritani"
                            1 => "K&#46;L&#46; Medina"
                            2 => "Y&#46; Tomiyama"
                            3 => "J&#46; Ishikawa"
                            4 => "Y&#46; Okajima"
                            5 => "M&#46; Ogawa"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1038/76233"
                      "Revista" => array:6 [
                        "tituloSerie" => "Nat Med&#46;"
                        "fecha" => "2000"
                        "volumen" => "6"
                        "paginaInicial" => "659"
                        "paginaFinal" => "699"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10835682"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib0045"
              "etiqueta" => "&#91;9&#93;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "TLSP&#58; finally in the limelight"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "W&#46;J&#46; Leonard"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1038/ni0702-605"
                      "Revista" => array:6 [
                        "tituloSerie" => "Nat Immunol&#46;"
                        "fecha" => "2002"
                        "volumen" => "3"
                        "paginaInicial" => "605"
                        "paginaFinal" => "607"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12087416"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib0050"
              "etiqueta" => "&#91;10&#93;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "What is Good&#39;s syndrome&#63; Immunolog-ical abnormalities in patients with thymoma"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "P&#46; Kelleher"
                            1 => "S&#46;A&#46; Misbah"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "J Clin Pathol&#46;"
                        "fecha" => "2003"
                        "volumen" => "56"
                        "paginaInicial" => "12"
                        "paginaFinal" => "16"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12499426"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            10 => array:3 [
              "identificador" => "bib0055"
              "etiqueta" => "&#91;11&#93;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Good&#39;s syndrome remains a mystery after 55 years&#58; a systematic review of the scientific evidence"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "T&#46; Kelesidis"
                            1 => "O&#46; Yang"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.clim.2010.01.006"
                      "Revista" => array:6 [
                        "tituloSerie" => "Clin Immunol&#46;"
                        "fecha" => "2010"
                        "volumen" => "135"
                        "paginaInicial" => "347"
                        "paginaFinal" => "363"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20149753"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
  ]
  "idiomaDefecto" => "en"
  "url" => "/21735115/0000001700000006/v1_201305151553/S2173511511000790/v1_201305151553/en/main.assets"
  "Apartado" => array:4 [
    "identificador" => "9692"
    "tipo" => "SECCION"
    "en" => array:2 [
      "titulo" => "Case report"
      "idiomaDefecto" => true
    ]
    "idiomaDefecto" => "en"
  ]
  "PDF" => "https://static.elsevier.es/multimedia/21735115/0000001700000006/v1_201305151553/S2173511511000790/v1_201305151553/en/main.pdf?idApp=UINPBA00004E&text.app=https://journalpulmonology.org/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173511511000790?idApp=UINPBA00004E"
]
Share
Journal Information
Vol. 17. Issue 6.
Pages 272-274 (November - December 2011)
Share
Share
Download PDF
More article options
Vol. 17. Issue 6.
Pages 272-274 (November - December 2011)
Case report
Full text access
Haemophilus influenzae pneumonia and immunodeficiency in association with thymoma–A presentation of Good's Syndrome
Pneumonia por Haemophilus Influenzae e imunodeficiência associadas a timoma–uma apresentação da Síndrome de Good
Visits
936
A. Fahima,
Corresponding author
ahmedfahim@doctors.org.uk

Corresponding author.
, M. Abuzakoukb, S.P. Harta
a Division of Cardiovascular and Respiratory Studies, Castle Hill Hospital, Castle Road, Cottingham, United Kingdom
b Department of Immunology, Hull Royal Infirmary, Anlaby Road, Hull, United Kingdom
This item has received
Article information
Abstract
Introduction

Good's Syndrome is a rare cause of immunodeficiency associated with thymoma. Patients with this syndrome are prone to infections with encapsulated microorganisms. The diagnosis may be delayed for a considerable time period even after the thymectomy. Case presentation: We describe the case of a 70-year-old woman with a background of thymec-tomy who presented with pneumonia and gram negative sepsis. Haemophilus influenzae was found in blood cultures. Moreover, there was evidence of impaired B and T cell immunity con-sistent with Good's Syndrome. She was commenced on immunoglobulin replacement following treatment of sepsis and remains well 18 months after the initial presentation.

Conclusion

This case illustrates the importance of considering Good's Syndrome in the con-text of pneumonia and immunodeficiency associated with encapsulated organisms such as Haemophilus influenzae. This clinical entity is associated with a significant mortality and should be considered as a cause of immunodeficiency even years after thymectomy.

Keywords:
Respiratory infections
Immunodeficiency
Thymoma
Resumo

Introdução: A Síndrome de Good é uma causa rara da imunodeficiência associada ao timoma. Os pacientes com esta síndrome são propensos a infecções por microrganismos encapsulados. O diagnóstico pode ser atrasado por bastante tempo, mesmo após a timectomia. Apresentação do Caso: Descrevemos o caso de uma mulher de 70 anos com antecedentes de timectomia, que apresentava pneumonia e sepsis por agente gram negativo. O Haemophilus influenzae foi isolado em hemoculturas. Além disso, evidência de alterações da imunidade celular B e T, consistente com a Síndrome de Good. A doente iniciou terapêutica de substituição com imunoglobulina seguida de tratamento da sepsis e continua bem 18 meses após a apresentação inicial. Conclusão: Este caso ilustra a importância de considerar a Síndrome de Good no contexto da pneumonia e imunodeficiência associadas a organismos encapsulados, como Haemophilus influenzae. Esta entidade clínica está associada a uma mortalidade significativa e deve ser considerada como uma causa de imunodeficiência mesmo anos depois da timectomia.

Palavras chave:
Infecções respiratórias
Imunodeficiência
Timoma
Full text is only aviable in PDF
References
[1]
R.A. Good.
Agammaglobulinaemia–a provocative experiment of nature.
Bull Univ Minnesota., 26 (1954), pp. 1-19
[2]
A.R. Hayward.
Hypogammaglobulinemia with deficiency of pre-B cells.
Lancet., 1 (1978), pp. 1014-1015
[3]
E.B. Mitchell, T.A. Platts Mills, R.S. Pereira, V. Malkovska, A.D. Webster.
Acquired basophil and eosinophil deficiency in a patient with hypogammaglobulinemia associated with thymoma.
Clin Lab Haematol., 5 (1983), pp. 253-257
[4]
P.E. Tarr, M.C. Sneller, L.J. Mechanic, A. Economides, C.M. Eger, W. Strober, et al.
Infections in patients with immunodeficiency with thymoma (Good syndrome) Report of 5 cases and review of the literature.
Medicine., 80 (2001), pp. 123-133
[5]
W.D. Murray, J.N. Webb.
Thymoma associated with hypogam-maglobulinaemia and pure red cell aplasia.
Am J Med., 41 (1966), pp. 974-980
[6]
D.G. Davila, D.H. Ryan, Thymoma.
hypogammaglobulinaemia and pernicious anemia.
South Med J., 79 (1986), pp. 904-906
[7]
E.S. Mongan, W.A. Kern Jr., R. Terry.
Hypogammaglobulinaemia with thymoma, haemolytic anemia, and disseminated infection with cytomegalovirus.
Ann Intern Med., 65 (1966), pp. 548-554
[8]
K. Oritani, K.L. Medina, Y. Tomiyama, J. Ishikawa, Y. Okajima, M. Ogawa, et al.
Limitin: an interferon-like cytokine that preferentially influences B lymphocyte precursors.
Nat Med., 6 (2000), pp. 659-699
[9]
W.J. Leonard.
TLSP: finally in the limelight.
Nat Immunol., 3 (2002), pp. 605-607
[10]
P. Kelleher, S.A. Misbah.
What is Good's syndrome? Immunolog-ical abnormalities in patients with thymoma.
J Clin Pathol., 56 (2003), pp. 12-16
[11]
T. Kelesidis, O. Yang.
Good's syndrome remains a mystery after 55 years: a systematic review of the scientific evidence.
Clin Immunol., 135 (2010), pp. 347-363
Download PDF
Pulmonology
Article options
Tools

Are you a health professional able to prescribe or dispense drugs?