A Case of Good Syndrome with Pulmonary Lesions Similar to Diffuse Panbronchiolitis

Takaaki Ogoshi; Hiroshi Ishimoto; Kazuhiro Yatera; Keishi Oda; Kentarou Akata; Kei Yamasaki; Takashi Kido; Toshinori Kawanami; Chiharu Yoshii; Hiroshi Mukae

doi:10.2169/internalmedicine.51.7028

CASE REPORTS

A Case of Good Syndrome with Pulmonary Lesions Similar to Diffuse Panbronchiolitis

Takaaki Ogoshi, Hiroshi Ishimoto, Kazuhiro Yatera, Keishi Oda, Kentarou Akata, Kei Yamasaki, Takashi Kido, Toshinori Kawanami, Chiharu Yoshii, Hiroshi Mukae

Author information

Takaaki Ogoshi
Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan
Department of Respiratory Medicine, Wakamatsu Hospital of the University of Occupational and Environmental Health, Japan
Hiroshi Ishimoto
Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan
Kazuhiro Yatera
Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan
Keishi Oda
Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan
Kentarou Akata
Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan
Kei Yamasaki
Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan
Takashi Kido
Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan
Toshinori Kawanami
Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan
Chiharu Yoshii
Department of Respiratory Medicine, Wakamatsu Hospital of the University of Occupational and Environmental Health, Japan
Hiroshi Mukae
Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan

Keywords: diffuse panbronchiolitis, DPB, Good syndrome, azithromycin, clarithromycin

JOURNAL OPEN ACCESS

2012 Volume 51 Issue 9 Pages 1087-1091

DOI https://doi.org/10.2169/internalmedicine.51.7028

Details

Abstract

We herein present a case of Good syndrome complicated by diffuse pulmonary lesions similar to diffuse panbronchiolitis (DPB). A 45-year-old Japanese man was referred to our department due to recurrent lower respiratory tract infections that had started and ameliorated nine months after thymectomy for pure red cell aplasia and myasthenia gravis. Diffuse centrilobular opacities on chest computed tomography and positivity for HLA-B54 were consistent with DPB. Additionally, hypogammaglobulinemia and a marked decrease of B-lymphocytes were observed, and therefore Good syndrome was considered. Combination therapy with azithromycin and clarithromycin alleviated the patient's respiratory symptoms and reduced the exacerbation of chronic bronchitis.

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