胸腺腫を切除したGood症候群の1例

Surgical Treatment for Thymoma with Good’s Syndrome；Report of a Case

はじめに　Good症候群は胸腺腫に低ガンマグロブリン血症が合併した疾患で，1954年にGoodが提唱した非常にまれな疾患である1）．われわれは，肺炎の治療に難渋したことが契機となり低γグロブリン血症が発見され，術前の免疫グロブリン補充療法により胸腺摘出術後に感染症などの合併症なく経過した症例を経験したので報告する．

A 50-year-old man was admitted to our hospital for severe pneumonia. An anterior mediastinum tumor and the hypogammaglobulinaemia were detected during treatment of pneumonia, and Good’s syndrome was diagnosed. The clinical characteristics of Good’s syndrome are increased susceptibility to bacterial infections and opportunistic viral and fungal infections. We planned thymectomy with the perioperative supplementation of immunoganmmagloblin to prevent perioperative infectious complications after pneumonia recovered completely. Extended thymo-thymectomy was performed. Pathological examination revealed type AB thymoma. The hypogammaglobulinaemia did not improved following thymectomy, and the patient had to be treated by immunoglobulin supplementation to maintain adequate trough immunoglobulin G （IgG） values.