{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T05:09:17Z","timestamp":1788930557957,"version":"build-2803163510"},"reference-count":14,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T00:00:00Z","timestamp":1788912000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:p>\n                    The coexistence of thymoma-associated multiorgan autoimmunity (TAMA) and Good\u2019s syndrome creates a challenging clinical scenario in which autoimmunity and profound immunodeficiency occur simultaneously. Here, we report a 37-year-old female with invasive WHO Type B3 thymoma and myasthenia gravis (MG) who developed progressive erythroderma-like skin lesions with graft-versus-host disease-like interface dermatitis. Immunological evaluation revealed marked hypogammaglobulinemia, absent circulating B cells, reduced CD4\n                    <jats:sup>+<\/jats:sup>\n                    T cells, and an inverted CD4\n                    <jats:sup>+<\/jats:sup>\n                    \/CD8\n                    <jats:sup>+<\/jats:sup>\n                    ratio. During a subsequent myasthenic crisis, severe immune dysfunction and active pulmonary infection were already present. Because conventional rapid immunomodulatory options were limited, efgartigimod and eculizumab were administered sequentially. The pulmonary infection continued to progress, and the patient ultimately died. This case highlights the importance of immune and infection risk assessment before potent immunomodulatory therapy.\n                  <\/jats:p>","DOI":"10.3389\/fimmu.2026.1916812","type":"journal-article","created":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T04:43:49Z","timestamp":1788929029000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Navigating coexisting autoimmunity and immunodeficiency in thymoma: a case report of TAMA, Good\u2019s syndrome, and myasthenic crisis"],"prefix":"10.3389","volume":"17","author":[{"given":"Youwei","family":"Hao","sequence":"first","affiliation":[{"name":"Department of Neurology, The First Hospital of Shanxi Medical University","place":["Taiyuan, Shanxi, China"]},{"name":"The First Clinical Medical College, Shanxi Medical University","place":["Taiyuan, Shanxi, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lizhen","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Neurology, The First Hospital of Shanxi Medical University","place":["Taiyuan, Shanxi, China"]},{"name":"The First Clinical Medical College, Shanxi Medical University","place":["Taiyuan, Shanxi, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ke","family":"Zheng","sequence":"additional","affiliation":[{"name":"Department of Neurology, The First Hospital of Shanxi Medical University","place":["Taiyuan, Shanxi, China"]},{"name":"The First Clinical Medical College, Shanxi Medical University","place":["Taiyuan, Shanxi, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Renlong","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Neurology, The First Hospital of Shanxi Medical University","place":["Taiyuan, Shanxi, China"]},{"name":"The First Clinical Medical College, Shanxi Medical University","place":["Taiyuan, Shanxi, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qi","family":"Wen","sequence":"additional","affiliation":[{"name":"Department of Neurology, The First Hospital of Shanxi Medical University","place":["Taiyuan, Shanxi, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jianli","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Neurology, The First Hospital of Shanxi Medical University","place":["Taiyuan, Shanxi, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Neurology, The First Hospital of Shanxi Medical University","place":["Taiyuan, Shanxi, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Neurology, The First Hospital of Shanxi Medical University","place":["Taiyuan, Shanxi, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hongxia","family":"He","sequence":"additional","affiliation":[{"name":"Department of Dermatology, The First Hospital of Shanxi Medical University","place":["Taiyuan, Shanxi, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruifang","family":"Bai","sequence":"additional","affiliation":[{"name":"Department of Neurology, The First Hospital of Shanxi Medical University","place":["Taiyuan, Shanxi, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xueli","family":"Chang","sequence":"additional","affiliation":[{"name":"Department of Neurology, The First Hospital of Shanxi Medical University","place":["Taiyuan, Shanxi, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,9]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1111\/jdv.19917","article-title":"Cutaneous manifestations of thymoma-associated multiorgan autoimmunity: A systematic review","volume":"38","author":"Cara-Gualda","year":"2024","journal-title":"J Eur Acad Dermatol Venereology JEADV"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1097\/jto.0000000000000324","article-title":"Multiorgan autoimmune manifestations associated with thymoma","volume":"10","author":"Thomas","year":"2015","journal-title":"J Thorac Oncol Off Publ Int Assoc For Study Lung Cancer"},{"key":"B3","doi-asserted-by":"publisher","first-page":"606","DOI":"10.1111\/jgh.15692","article-title":"Gastrointestinal: Autoimmune enteropathy associated with thymoma","volume":"37","author":"Gu","year":"2022","journal-title":"J Gastroenterol Hepatol"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1097\/00000478-199502000-00011","article-title":"Graft-versus-host-like colitis associated with Malignant thymoma","volume":"19","author":"Kornacki","year":"1995","journal-title":"Am J Surg Pathol"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2007.02.027","article-title":"Thymoma-associated multiorgan autoimmunity: a graft-versus-host-like disease","volume":"57","author":"Wadhera","year":"2007","journal-title":"J Am Acad Dermatol"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1016\/j.clim.2010.01.006","article-title":"Good's syndrome remains a mystery after 55 years: A systematic review of the scientific evidence","volume":"135","author":"Kelesidis","year":"2010","journal-title":"Clin Immunol (Orlando Fla)"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1196\/annals.1405.018","article-title":"Common cellular and diverse genetic basis of thymoma-associated myasthenia gravis: role of MHC class 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Myasthenia Gravis Clinical Study Group","volume":"41","author":"Gajdos","year":"1997","journal-title":"Ann Neurol"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.1212\/wnl.0000000000007600","article-title":"Randomized phase 2 study of FcRn antagonist efgartigimod in generalized myasthenia gravis","volume":"92","author":"Howard","year":"2019","journal-title":"Neurology"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.1016\/s1474-4422(17)30369-1","article-title":"Safety and efficacy of eculizumab in anti-acetylcholine receptor antibody-positive refractory generalised myasthenia gravis (REGAIN): a phase 3, randomised, double-blind, placebo-controlled, multicentre study","volume":"16","author":"Howard","year":"2017","journal-title":"Lancet Neurol"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.1016\/j.jinf.2019.11.015","article-title":"Antibiotic prophylaxis in vaccinated eculizumab recipients who developed meningococcal disease","volume":"80","author":"Crew","year":"2020","journal-title":"J Infection"}],"container-title":["Frontiers in Immunology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fimmu.2026.1916812\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T04:43:56Z","timestamp":1788929036000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fimmu.2026.1916812\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,9]]},"references-count":14,"alternative-id":["10.3389\/fimmu.2026.1916812"],"URL":"https:\/\/doi.org\/10.3389\/fimmu.2026.1916812","relation":{},"ISSN":["1664-3224"],"issn-type":[{"value":"1664-3224","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,9]]},"article-number":"1916812"}}