Literature Review
We searched all cases up to October 2022 using China National Knowledge
Infrastructure database, Wangfang database and China Science and
Technology Journal Database, and PubMed database. Keywords included
Good’s syndrome, Good syndrome, thymoma, diarrhea, Cytomegalovirus
infection. According to the literature, 10 patients diagnosed with GS
and CMV gastrointestinal infection meet our inclusion criteria (Table2 ).
It is reported that 8 patients had diarrhea without specific endoscopic
manifestation. Although one case showed normal macroscopic appearance of
the colon, the random colonic biopsy revealed CMV inclusion
bodies[7]. Two cases also manifested as chronic diarrhea due to CMV
enteritis and ulcerative colitis[5, 15]. All patients received
immunoglobulin replacement therapy. Except for two cases (one case of
CMV infection confirmed by necropsy, and one case did not describe the
regime of antiviral agent), eight cases received ganciclovir as the
initial treatment for CMV, and four cases switched to Foscarnet due to
no response or recurrence of diarrhea, and two cases finally switched to
cidofovir due to no response or intolerance of Foscarnet.
Four patients deteriorated and died
due to fulminant bronchopneumonia, sepsis, recurrent colitis and colonic
perforation, and neurological deterioration with a refractory
supraconvulsive state, respectively.