Progressive Multifocal Leukoencephalopathy in a Patient with Good Syndrome 11 Years after Thymectomy

Kim, Woo-Jun; Nam, Woo Hyuk; Im, Jae Hyoung; Kwon, Soonwook

doi:2026.44.3.220

J Korean Neurol Assoc > Volume 44(3); 2026 > Article

Case Report

Journal of the Korean Neurological Association 2026;44(3): 220-225. doi: https://doi.org/10.17340/jkna.2026.0016

가슴샘종 절제술 11년 후 발생한 굿(Good)증후군 환자의 진행다초점백질뇌병증

김우준¹, 남우혁¹, 임재형², 권순욱^1,3

¹인하대병원 신경과
²인하대학교 의과대학 내과학교실 감염내과
³인하대학교 의과대학 신경과학교실

Progressive Multifocal Leukoencephalopathy in a Patient with Good Syndrome 11 Years after Thymectomy

Woo-Jun Kim MD¹, Woo Hyuk Nam MD¹, Jae Hyoung Im MD², Soonwook Kwon MD, PhD^1,3

¹Department of Neurology, Inha University Hospital, Incheon, Koreaa
²Division of Infectious Diseases, Department of Internal Medicine, Inha University College of Medicine, Incheon, Korea
³Department of Neurology, Inha University College of Medicine, Incheon, Korea

Corresponding Author: Soonwook Kwon ,Tel: +82-32-890-3708, Fax: +82-504-036-1753, Email: sw1214kwon@inha.ac.kr

Received: March 16, 2026 Revised: April 21, 2026 Accepted: April 21, 2026 Published online: August 1, 2026

Abstract

Progressive multifocal leukoencephalopathy (PML) occurs in immunocompromised patients. We report a 60-year-old woman with rapidly progressive aphasia and cognitive decline 11 years after thymectomy. Brain magnetic resonance imaging revealed asymmetric, non-enhancing confluent white matter lesions. Laboratory tests showed hypogammaglobulinemia, reduced B cells, and a reversed CD4/CD8 ratio, consistent with Good syndrome. John Cunningham virus DNA was detected in cerebrospinal fluid, confirming PML. This case highlights that PML can occur in patients with Good syndrome even years after remote thymectomy.

Key Words: Leukoencephalopathy | progressive multifocal | Immunologic deficiency syndrome | Thymoma