Streptococcus B septic polyarthritis revealing Good's syndrome

Abstract We report on a 46-year-old woman, who developed streptococcus B septic polyarthritis in the context of septicemia of urinary origin. This case revealed a Good's syndrome whose diagnosis was made on the basis of a profound hypogammaglobulinaemia, a large decrease of peripheral B cells a...

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Bibliographic Details
Published in:Joint, bone, spine : revue du rhumatisme bone, spine : revue du rhumatisme, 2012-07, Vol.79 (4), p.412-414
Main Authors: Zabsonré, Joelle Tiendrebeogo, Laoubi, Khaled, Kemiche, Farid, Cerf-Payrastre, Isabelle, Pertuiset, Edouard
Format: Article
Language:English
Subjects:
Agammaglobulinemia - diagnosis
Anti-Bacterial Agents - therapeutic use
Arthritis, Infectious - diagnosis
Arthritis, Infectious - drug therapy
Arthritis, Infectious - microbiology
B-Lymphocytes
CD8-Positive T-Lymphocytes - pathology
Diagnosis, Differential
Drug Therapy, Combination
Female
Good's syndrome
Humans
Hypogammaglobulinemia
Immunoglobulins, Intravenous - administration & dosage
Internal Medicine
Middle Aged
Rheumatology
Septic arthritis
Streptococcal Infections - diagnosis
Streptococcal Infections - microbiology
Streptococcus agalactiae
Streptococcus B
Syndrome
Thymoma
Thymoma - diagnosis
Thymoma - surgery
Thymus Neoplasms - diagnosis
Thymus Neoplasms - surgery
Treatment Outcome
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Summary:Abstract We report on a 46-year-old woman, who developed streptococcus B septic polyarthritis in the context of septicemia of urinary origin. This case revealed a Good's syndrome whose diagnosis was made on the basis of a profound hypogammaglobulinaemia, a large decrease of peripheral B cells and a thymoma disclosed on chest computed tomography (CT) and confirmed by surgical removal (AB type). There was also an inversion of the peripheral CD4+/CD8+ T cell ratio and an increase of CD8+ T cells. The course of infection was favorable under treatment with antibiotics and intravenous immunoglobulin. Good's syndrome is a rare entity, which belongs to primary immunodeficiency syndromes. Its first manifestations appear late in life, usually after the age of 40. In front of hypogammaglobulinemia, it is necessary to search for Good's syndrome by practicing chest CT scan, looking for thymoma, which is constant, and peripheral lymphocytes phenotyping looking for B cell lymphopenia and the frequent T cell associated abnormalities.
ISSN:1297-319X
1778-7254
DOI:10.1016/j.jbspin.2012.03.009