Google Scholar | Citations: 16429| h-index: 32 | i10-index: 482
Good's Syndrome and Myasthenia Gravis: is there an association?
PDF (Portuguese (Brazil))

Keywords

Good's syndrome
Hypogammaglobulinemia
Thymoma
Myasthenia gravis
Neuroimmunology

How to Cite

Good’s Syndrome and Myasthenia Gravis: is there an association? (2025). Electronic Journal Collection Health, 25, e19228. https://doi.org/10.25248/reas.e19228.2025

Copyright © | All rights reserved.

The journal holds the exclusive copyright for the publication of this article under the terms of Brazilian law 9610/98.

Partial reproduction
The use of parts of the texts, figures and questionnaire of the article is free, being mandatory the citation of the authors and journal.

Total reproduction
It is expressly prohibited and must be authorized by the journal.

Abstract

Objective: To investigate a possible association between Myasthenia Gravis (MG) and Good's Syndrome (GS), since some patients can present them simultaneously and both are involved with the immune system. Bibliographic review: The selected articles highlight the central role of the thymus in both immune competence and control, suggesting that the connection between GS and MG is mainly related to thymic changes present in GS, which contribute to immunological dysregulation, leading to the production of antibodies anti-acetylcholine receptor (anti-AchR), characteristic of MG. These changes in the thymus are associated with an inadequate immune response, where T and B cells can interact anomalously, favoring autoimmunity. Furthermore, the presence of thymomas, frequently observed in patients with MG, highlights the importance of this organ in the genesis of the disease. Therefore, studies on the interaction between the immune system and the thymus offer new perspectives for understanding the association between GS and MG. Final considerations: The literature suggests an association between MG and GS. Therefore, GS should be considered in patients diagnosed with MG and vice versa.

PDF (Portuguese (Brazil))

References

ALMEIDA FHS, et al. Miastenia gravis análise de 90 casos tratados com timectomia myasthenia gravis. Acta Cirúrgica Brasileira, 2000; 15: 53–56.

BERNARD C, et al. Timoma associado a doenças autoimunes: 85 casos e revisão de literatura. Revisões sobre autoimunidade, 2015; 15(1): 82-92.

BEDIM VB, et al. Imunodeficiência comum variável: relato de caso e revisão da literatura. HU Revista, 2016; 42: 1.

BLALOCK A, et al. Myasthenia gravis and tumors of the thymic region: report of a case in which the tumor was removed. Annals of Surgery, 1939; 110(4): 544-61.

BOILEAU J, et al. Autoimmunity in common variable immunodeficiency: Correlation with lymphocyte phenotype in the French DEFI study. Journal of Autoimmunity, 2011; 36(1): 25–32

CABALLERO-ÁVILA M, et al. Rituximab in myasthenia gravis: efficacy, associated infections and risk of induced hypogammaglobulinemia. Neuromuscular disorders: NMD, 2022; 32(8): 664–671.

CUNHA FMB, et al. Miastenia grave: avaliação clínica de 153 pacientes. Arquivos de Neuro- psiquiatria, 1999; 57(2B): 457–464.

CRUZ VR, et al. Aspectos epidemiológicos e clínicos de pacientes com diagnóstico de timoma e carcinoma tímico no estado de Pernambuco, Repositório Científico do IMIP, 2016.

DAVIS RD Jr, et al. Primary cysts and neoplasms of the mediastinum: recent changes in clinical presentation, methods of diagnosis, management, and results. Annals of Thoracic Surgery, 1987; 44(3): 229-37.

DETTERBECK FC. Clinical value of the WHO classification system of thymoma. The Annals of Thoracic Surgery, 2006; 81(6): 2328–2334.

DETTERBECK FC e ZEESHAN A. Thymoma: current diagnosis and treatment. Chinese Medical Journal, 2012.

GONZÁLEZ R, et al. Neoplasias epiteliales del timo: timoma y carcinoma tímico: Caracterización, tratamiento y variables asociadas a supervivencia. Revista chilena de cirugía, 2012; 64(6): 535-545.

ISHIZUCHI K, et al. Immunodeficiency in patients with thymoma-associated myasthenia gravis. Journal of neuroimmunology, 2022; 371(577950): 577950.

KAULING ALC, et al. Miastenia Gravis: Relato de Dois Casos e Revisão da Literatura. Revista Brasileira de Anestesiologia, 2011.

KELESIDIS T e YANG O. Good's syndrome remains a mystery after 55 years: A systematic review of the scientific evidence, Clinical Immunology, 2010; 135: 3.

KELLEHER P e MISBAH SA. What is Good’s syndrome? Immunological abnormalities in patients with thymoma. Journal of clinical pathology, 2003; 56(1): 12–16.

KURIHARA N, et al. Thymic carcinoma with myasthenia gravis: Two case reports, 2016, 27.

LANFERINE L, et al. Imunodeficiência comum variável: relato de caso e revisão da literatura.

LEE S, et al. A case of granulomatous lung disease in a patient with Good’s syndrome. 2008.

LIMA FA, et al. O papel do timo no desenvolvimento do sistema imune*. Pediatria (São Paulo), 2007; 29(1): 33-42.

LOPES A, et al. A propósito de um caso de imunodeficiência comum variável – Revisão das hipogamaglobulinemias, 2006; 12.

LUZ A R, et al. Miastenia Gravis: uma análise crítica dos métodos diagnósticos e condutas terapêuticas. Revista Eletrônica Acervo Saúde, 2022; 15(9): e11066.

MARX A, et al. Thymoma and paraneoplastic myasthenia gravis. Autoimmunity, 2010; 43(5-6): 413–427.

MARX A, et al. Thymus and autoimmunity. Springer, 2021; 2(2): 3.

MESQUITA J, et al. Sistema imunitário - parte II: fundamentos da resposta imunológica mediada por linfócitos T e B. Revista brasileira de reumatologia, 2010; 50(5): 552–580.

MONTEIRO RA, et al. Síndrome de Good: associação entre timoma, hipogamaglobulinemia, aplasia pura da série vermelha e parvovírus B19 – um estudo de caso. Revista Eletrônica Acervo Saúde, 2020; 40: e2289.

NETO P, et al. Hipogamaglobulinemia como fator de risco para infecção por Cryptococcus neoformans: a propósito de dois casos. Rev Soc Bras Med Trop., 2000; 33(6): 603-8.

PASCUZZI RM. The history of myasthenia gravis, 1994; 12(2): 231-242.

PÊGO FPM, et al. Timoma: discussão sobre tratamento e prognóstico. Jornal de Pneumologia, 2001; 27(6): 289–294.

Primary immunodeficiency diseases. Report of an IUIS scientific committee. International Union of Immunological Societies. Clin Exp Immunol 1999;118(suppl1):1–28

ROMI F. Thymoma in Myasthenia Gravis: From Diagnosis to Treatment, Department of Neurology, Haukeland University Hospital, 5021 Bergen, Norway, 2011; 474512.

RUFFINI E, et al. Thymoma: inter-relationships among World Health Organization histology, Masaoka staging and myasthenia gravis and their independent prognostic significance: a single-centre experience. Eur J Cardiothorac Surg, 2011; 40(1): 146-53.

SONG J, et al. Common Variable Immunodeficiency and Liver Involvement. Clinical Reviews in Allergy & Immunology, 2017; 55(3): 340–351.

JAMILOUX Y, et al.Thymomes et maladies auto-immunes [Thymoma and autoimmune diseases], 2018.

ZHANG T, et al. Case report of Ureaplasma urealyticum meningitis in a patient with thymoma and hypogammaglobulinaemia. BMC infectious diseases, 2021; 21(1): 1142