The association of thymoma and hypogammaglobulinemia is a well-documented parathymic syndrome described in 1968 by Jeunet and Good.1 Patients with this condition suffer from chronic infections with frequent exacerbations secondary to their attenuated immune response. We report herein the occurrence of bilateral nonsimultaneous recurrent ocular herpes simplex in an individual with this syndrome.
Report of a Case.
—A 78-year-old white woman was treated repeatedly during a 3-year period for purulent sinusitis, chronic bronchitis, and bilateral recurrent herpes simplex, often with geographic ulcers (Figure). The epithelial keratitis always responded well to antiviral agents. The patient was noted to have a mediastinal enlargement that was diagnosed with needle biopsy as thymoma. An immunologic evaluation revealed no detectable IgA levels and attenuated IgM and IgG levels of 0.15 g/L and 1.44 g/L, respectively. A serum protein electrophoresis demonstrated a very low gamma globulin curve with no monoclonal spikes. Lymphocyte studies revealed remarkably
Eiferman RA, Hoffman RS, Pence HL. Good Syndrome and Herpetic Keratitis. Arch Ophthalmol. 1993;111(6):736. doi:10.1001/archopht.1993.01090060022012