Top

Published in:

01-06-2020 | Primary Immunodeficiency | Case Report

Herpes simplex virus type 2 meningitis as a manifestation of Good’s syndrome

Authors: Lorena Matta, María Camila Ramírez-Velasco, Andrés Felipe Zea-Vera

Published in: Journal of NeuroVirology | Issue 3/2020

Abstract

Good’s syndrome is a primary immunodeficiency phenocopy characterized for thymoma and immunodeficiency. The most frequent clinical presentation is recurrent or opportunistic infections, hematological alterations, and chronic diarrhea. We treated a 66-year-old man who consulted for 5 days of headache and diplopia with right sixth cranial nerve palsy at examination. Patient reported chronic diarrhea and prolonged febrile syndrome accompanied by weight loss of 23 kg in the last year. Exhaustive evaluation revealed Herpes simplex virus (HSV) type 2 meningitis, eosinophilic colitis, and type A thymoma. Severe antibody deficiency (hypogammaglobulinemia) associated with thymoma confirmed the diagnosis of Good’s syndrome.

Burbelo PD, Browne SK, Sampaio EP, Giaccone G, Zaman R, Kristosturyan E, Rajan A, Ding L, Ching KH, Berman A, Oliveira JB, Hsu AP, Klimavicz CM, Iadarola MJ, Holland SM (2010) Anti-cytokine autoantibodies are associated with opportunistic infection in patients with thymic neoplasia. Blood 116(23):4848–4858CrossRef

Cucchiara BL, Forman MS, McGarvey ML, Kasner SE, King D (2003) Fatal subacute cytomegalovirus encephalitis associated with hypogammaglobulinemia and thymoma. Mayo Clin Proc 78(2):223–227CrossRef

Good RA, Varco RL (1955) A clinical and experimental study of agammaglobulinemia. J Lancet 75(6):245–271PubMed

Jansen, A., M. van Deuren, J. Miller, J. Litzman, J. de Gracia, M. Saenz-Cuesta, A. Szaflarska, T. Martelius, Y. Takiguchi, S. Patel, S. Misbah, A. Simon and G. Good syndrome Study (2016). Prognosis of Good syndrome: mortality and morbidity of thymoma associated immunodeficiency in perspective. Clin Immunol 171: 12–17

Kauffman CA, Linnemann CC Jr, Alvira MM (1979) Cytomegalovirus encephalitis associated with thymoma and immunoglobulin deficiency. Am J Med 67(4):724–728CrossRef

Kelesidis T, Yang O (2010) Good’s syndrome remains a mystery after 55 years: a systematic review of the scientific evidence. Clin Immunol 135(3):347–363CrossRef

Kelleher P, Misbah SA (2003) What is Good’s syndrome? Immunological abnormalities in patients with thymoma. J Clin Pathol 56(1):12–16CrossRef

Lubinski JM, Lazear HM, Awasthi S, Wang F, Friedman HM (2011) The herpes simplex virus 1 IgG fc receptor blocks antibody-mediated complement activation and antibody-dependent cellular cytotoxicity in vivo. J Virol 85(7):3239–3249CrossRef

Mean M, Schaller MD, Asner S, Meylan P, Pagani JL, Tarr P, Eggimann P (2009) Thymoma, immunodeficiency, and herpes simplex virus infections. Med Mal Infect 39(5):344–347CrossRef

Para MF, Goldstein L, Spear PG (1982) Similarities and differences in the Fc-binding glycoprotein (gE) of herpes simplex virus types 1 and 2 and tentative mapping of the viral gene for this glycoprotein. J Virol 41(1):137–144CrossRef

Picard C, Bobby Gaspar H, Al-Herz W, Bousfiha A, Casanova JL, Chatila T, Crow YJ, Cunningham-Rundles C, Etzioni A, Franco JL, Holland SM, Klein C, Morio T, Ochs HD, Oksenhendler E, Puck J, Tang MLK, Tangye SG, Torgerson TR, Sullivan KE (2018) International Union of Immunological Societies: 2017 primary immunodeficiency diseases committee report on inborn errors of immunity. J Clin Immunol 38(1):96–128CrossRef

Rosenberg E, Dent PB, Denburg JA (2016) Primary immune deficiencies in the adult: a previously underrecognized common condition. J Allergy Clin Immunol Pract 4(6):1101–1107CrossRef

Rosenow EC 3rd, Hurley BT (1984) Disorders of the thymus. A review. Arch Intern Med 144(4):763–770CrossRef

Squintani G, Ferrari S, Bazzoli E, Eleopra R, La Monaca C, Cagliari E, Zanusso G, Mantovan MC, Monaco S (2010) Progressive multifocal leukoencephalopathy in a patient with Good’s syndrome. Int J Infect Dis 14(5):e444–e447CrossRef

Striano P, Tortora F, Evoli A, Palmieri G, Elefante A, Zara F, Tarr PE, Striano S (2007) Periodic myoclonus due to cytomegalovirus encephalitis in a patient with good syndrome. Arch Neurol 64(2):277–279CrossRef

Sveinsson O, Matell H, Herrman L (2013) Progressive multifocal leukoencephalopathy in a patient with Good’s syndrome. BMJ Case Rep 2013

Tavakol M, Mahdaviani SA, Ghaemi MR, Vaezi M, Dorudinia A, Jamaati H, Velayati AA (2018) Good’s syndrome-association of the late onset combined immunodeficiency with thymoma: review of literature and case report. Iran J Allergy Asthma Immunol 17(1):85–93PubMed

Ternavasio-de la Vega HG, Velasco-Tirado V, Pozo-Rosado L, Soler-Fernandez MC, Perez-Andres M, Orfao A, Sanchez-Sanchez R, Gonzalez-Villaron L (2011) Persistence of immunological alterations after thymectomy in Good’s syndrome: a clue to its pathogenesis. Cytometry B Clin Cytom 80(5):339–342CrossRef

Ueno S, Sekimoto-Tsuboi S, Ishiguro Y, Koinuma T, Eguchi H, Machida Y, Hattori N, Miwa H (2015) Good’s syndrome with opportunistic infection of the central nervous system: a case report. BMC Neurol 15:150CrossRef

Title: Herpes simplex virus type 2 meningitis as a manifestation of Good’s syndrome
Authors: Lorena Matta
María Camila Ramírez-Velasco
Andrés Felipe Zea-Vera
Publication date: 01-06-2020
Publisher: Springer International Publishing
Keywords: Primary Immunodeficiency
Herpes Virus
Opportunistic Infection
Thymoma
Immunodeficiency
Meningitis
Thymoma
Diarrhea
Diarrhea
Published in: Journal of NeuroVirology / Issue 3/2020
Print ISSN: 1355-0284
Electronic ISSN: 1538-2443
DOI: https://doi.org/10.1007/s13365-019-00819-x

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Herpes simplex virus type 2 meningitis as a manifestation of Good’s syndrome

Abstract

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 3/2020

Zika virus infection in chemosensory cells

Expression of TSLC1 in patients with HAM/TSP

Varicella zoster virus (VZV) oculomeningoencephalomyeloradiculitis: a previously undescribed constellation

Acupuncture in the treatment of HTLV-I-associated myelopathy / tropical spastic Paraparesis

Repeated viral meningitis in a newborn

The “Three Italy” of the COVID-19 epidemic and the possible involvement of SARS-CoV-2 in triggering complications other than pneumonia