Case Report-Secondary Antibody Deficiency Due to Endogenous Hypercortisolism

Front Immunol. 2020 Jul 7:11:1435. doi: 10.3389/fimmu.2020.01435. eCollection 2020.

Abstract

Therapeutic corticosteroids have an immunosuppressive function involving several pathways, including lymphocytopenia and hypogammaglobulinemia. While these effects have been well-described in patients that received corticosteroids for therapeutic reasons, the effects of endogenous corticosteroids on the immune system are less well-understood. Here, we describe a 21-year old patient with hypercortisolism due to an ACTH producing thymic tumor. In this patient, we observed a decrease in some of the immunoglobulin classes, and in specific B and T cell populations that resembled effects caused by corticosteroid treatment. IgG levels were restored following treatment and normalization of the hypercortisolism.

Keywords: endogenous hypercortisolism; hypogammaglobulinemia; immune deficiency; lymphocytopenia; secondary antibody deficiency.

Publication types

  • Case Reports

MeSH terms

  • Adrenocorticotropic Hormone / metabolism*
  • Agammaglobulinemia / diagnosis*
  • Agammaglobulinemia / etiology
  • B-Lymphocytes / physiology*
  • Cushing Syndrome / complications
  • Cushing Syndrome / diagnosis*
  • Humans
  • Lymphopenia
  • Male
  • T-Lymphocytes / physiology*
  • Thymectomy
  • Thymus Neoplasms / diagnosis*
  • Thymus Neoplasms / etiology

Substances

  • Adrenocorticotropic Hormone