[Pubmed] Understanding the uncommon: Insights into thymoma associated immunodeficiency

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Asian Pac J Allergy Immunol. 2025 Feb 16. doi: 10.12932/AP-080724-1887. Online ahead of print.

ABSTRACT

BACKGROUND: Thymoma-associated immunodeficiency (TAI) is a rare, acquired adult-onset immunodeficiency. It includes the classic form of Good syndrome (GS), characterized by thymoma and hypogammaglobulinemia, as well as a non-classic form of GS. This condition leads to specific or combined deficiencies in both B- and T-cells, causing considerable morbidity and mortality, although the underlying immunopathology is still not well understood.

OBJECTIVE: In this study, we examine the clinical features, laboratory investigations, immunological analysis and treatment outcomes of 21 patients with TAI in our institution, and its associated comorbidities and complications.

METHODS: Patients with thymoma and recurrent infections who were followed up in our immunodeficiency clinic between 1 January 1999 and 1 December 2023 were identified. Clinical information, laboratory, treatment and outcome data were extracted from the medical records. Seven patients agreed to provide additional blood samples for anti-cytokine antibodies profiling.

RESULTS: Of the 21 TAI patients, 12 (57.1%) were females and the mean age at diagnosis of TAI was 61.3 ± 9.2 years. 19 patients had classic GS. 12 (57.1%) had underlying bronchiectasis, 5 (23.8%) had sinusitis and 5 (23.8%) developed malignancy other than thymic carcinoma after diagnosis of thymoma. 10 patients (47.6%) developed autoimmune conditions including myasthenia gravis, polymyositis, lichen planus, vasculitis and ulcerative colitis. One patient was found to have high titre of neutralizing anti-interferon alpha antibodies as well as medium titre of neutralizing anti-interleukin 17 antibodies. 9 patients died at a median of 4.2 (IQR 1.98 - 4.9) years after diagnosis of TAI.

CONCLUSIONS: TAI is associated with significant morbidity and mortality. The syndrome leads to a plethora of opportunistic infections, autoimmune complications and malignancy.

PMID:39955639 | DOI:10.12932/AP-080724-1887


Source: https://pubmed.ncbi.nlm.nih.gov/3995563 ... t9+e462414