Clinical manifestations and long-term prognosis of Good syndrome: Results from a single-center cohort study from China

Abstract

Objective

To describe clinical features and long-term prognosis in patients with Good syndrome (GS).

Methods

We retrospectively reviewed medical records of GS patients at Peking Union Medical College Hospital from January 2001 to May 2019. Data regarding clinical manifestations and treatments were collected. Patients were routinely followed-up via clinical and telephone interviews, and survival analysis was performed with Kaplan-Meier analysis.

Results

Twenty-four patients were identified, including eight males and 16 females, with a median age at diagnosis of 58 years (interquartile range [IQR], 52–62 years). Twelve patients (50%) had autoimmune manifestations. Multi-organ involvements included musculoskeletal (37.5%), respiratory (33.3%), gastrointestinal (29.2%), hematologic (29.2%) systems, et.al. Infections were detected in 23 (95.8%) patients, mostly located in lung (69.6%), blood (26.1%), and gastrointestinal tract (21.7%). Thymectomy was performed in 23 patients, with the most common histology of type AB (10, 47.6%). Twenty-one patients were consecutively followed-up with a median follow-up of 84 (IQR, 48–116) months and 11 (52.4%) died, mainly due to infection (8/11, 72.7%). The 5- and 10-year survival rates were 90% (95% confidence interval [CI], 77.8–100%) and 38.5% (95% CI, 19.6–75.5%), respectively.

Conclusion

GS patients tended to present with various infections and autoimmune manifestations. The 10-year survival rate from the Chinese population was poor, mainly due to infections.

Keywords:

• Good syndrome
• autoimmunity
• thymoma
• infection
• prognosis

Conflict of interest

None.

Additional information

Funding

This work was supported by grants from the National Natural Science Fund [No. 81801633, 81771764, 8163000787], CAMS Initiative for Innovative Medicine [2020-I2M-C&T-B-011, 2020-I2M-C&T-A-003] and the CAMS Chinese Academy of Medical Sciences Young Medical Talent Award Fund [No. 2018RC320005].