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Gastrointestinal pathology in Good’s syndrome, thinking beyond common variable immunodeficiency: a clinicopathological observation

Year: 2025

Type: article

Abstract: Good's syndrome (GS) is a rare immunodeficiency associated with thymoma, characterized by increased susceptibility to bacterial, viral, and fungal infections, along with autoimmune manifestations. Gastrointestinal symptoms are common in GS, yet its clinical and histopathological features remain underrecognized. Due to significant overlap in clinical presentation and immunological profiles, GS is frequently misdiagnosed as common variable immunodeficiency (CVID). While gastrointestinal pathology in CVID has been well-documented, data on gastrointestinal manifestations in GS are limited. In this study, we analyzed two cases of GS, both demonstrating marked reduction of plasma cells across multiple gastrointestinal sites, with variable intraepithelial lymphocytosis and mild to moderate villous blunting in the duodenum and features secondary to chronic norovirus infection in one case, and an invasive adenocarcinoma with notable depletion of lamina propria plasma cells in the other. Accurate recognition of GS is essential for pathologists and clinicians, given its poorer prognosis compared to CVID.

Source: Archiv für Pathologische Anatomie und Physiologie und für Klinische Medicin

DOI: 10.1007/s00428-025-04069-7

Authors: Pooja Navale, Ofer Zimmerman, James Wedner, Anupam Pande, Samuel Ballentine

Institutions: Cooper University Hospital, Cooper University Health Care, Washington University in St. Louis

Language: English

Topic: Immunodeficiency and Autoimmune Disorders

Subfield: Immunology

Field: Immunology and Microbiology

Domain: Life Sciences

SDG: Good health and well-being

Open Access status: hybrid

Estimated APC paid: $4,790