case_images: PMC11793036_01
case_images: Patient's clinical history and imaging. A, Timeline of viral infections and identification of the mediastinal mass, then diagnosed as thymoma. B, High-resolution chest computed tomography (CT) scan showing coronavirus disease 2019 (COVID-19) pneumonia, characterized by bilateral ground-glass areas associated with interstitial thickening, most extensively in the upper lung lobes and areas of pulmonary consolidation with dense streaks in the lower lobes bilaterally. C, CT scan showing right paracardiac mass with maximum transverse diameter of 5 cm (arrow). D, Low-dose positron emission tomography/CT scan with [18F]fluorodeoxyglucose showing medium accumulation in the right paracardiac mediastinal mass (arrow).
case_images: jiae321f1.jpg
case_images: PMC11793036_01_jiae321f1.jpg
case_images: jiae321-F1
case_images: His clinical history was characterized by infectious mononucleosis at 18 years of age, uncomplicated measles at 30 years of age, and chickenpox at 45 years of age (Figure 1A). During this hospitalization, thorax CT scan identified a 3-cm paracardiac mass, which had increased up to 5 cm at the time of COVID-19 pneumonia (Figure 1B-D). The answer came from the mediastinal mass, histologically diagnosed as type AB thymoma, which was metabolically active (Figure 1D).
case_images: Genetics and immunological response to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) of the patient and family. A, Pedigree and segregation of the TLR3 variant c.2660C > T, p.P554S and of the CCR5 variant c.554_585del, p.Ser185IlefsTer32 (CCR5Delta32). Proliferative response to SARS-CoV-2 spike protein peptides (B) and Wuhan spike receptor-binding domain immunoglobulin G levels (C) in the probands (I.1 and II.2) and 2 control cohorts; the assay cut-off is shown as a dashed line. D, Anti-type I interferon (IFN) autoantibodies: neutralization of type I IFNs (1 ng/mL of IFNs) detected in a luciferase-based cell reporter assay, in the patient plasma/serum (I.1) at different time points after coronavirus disease 2019 infection, before and after thymectomy, in the daughter (II.1) and in control groups (autoantibody-positive patients and healthy control without autoantibodies). Abbreviations: AAB, autoantibody; AU, arbitrary units; COVID-19, coronavirus disease 2019; IFN, interferon; IgG, immunoglobulin G; ISRE, interferon-stimulated response element; NS, not stimulated; RBD, receptor-binding domain; RLA, relative luciferase activity; SARS-CoV-2, severe acute respiratory syndrome coronavirus 2; SI, stimulation index; wt, wild type.
case_images: jiae321f2.jpg
case_images: PMC11793036_02_jiae321f2.jpg
case_images: jiae321-F2
case_images: Considering the risk of autoantibody production related to thymoma, we demonstrated the presence of autoantibodies neutralizing 1 ng/mL IFN-alpha and anti-IFN-omega autoantibodies in the patient (not in the daughter), even 6 months after thymectomy (Figure 2D).
case_images: PMC11793036_02
case_images: Genetics and immunological response to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) of the patient and family. A, Pedigree and segregation of the TLR3 variant c.2660C > T, p.P554S and of the CCR5 variant c.554_585del, p.Ser185IlefsTer32 (CCR5Delta32). Proliferative response to SARS-CoV-2 spike protein peptides (B) and Wuhan spike receptor-binding domain immunoglobulin G levels (C) in the probands (I.1 and II.2) and 2 control cohorts; the assay cut-off is shown as a dashed line. D, Anti-type I interferon (IFN) autoantibodies: neutralization of type I IFNs (1 ng/mL of IFNs) detected in a luciferase-based cell reporter assay, in the patient plasma/serum (I.1) at different time points after coronavirus disease 2019 infection, before and after thymectomy, in the daughter (II.1) and in control groups (autoantibody-positive patients and healthy control without autoantibodies). Abbreviations: AAB, autoantibody; AU, arbitrary units; COVID-19, coronavirus disease 2019; IFN, interferon; IgG, immunoglobulin G; ISRE, interferon-stimulated response element; NS, not stimulated; RBD, receptor-binding domain; RLA, relative luciferase activity; SARS-CoV-2, severe acute respiratory syndrome coronavirus 2; SI, stimulation index; wt, wild type.
case_images: jiae321f2.jpg
case_images: PMC11793036_02_jiae321f2.jpg
case_images: jiae321-F2
case_images: Considering the risk of autoantibody production related to thymoma, we demonstrated the presence of autoantibodies neutralizing 1 ng/mL IFN-alpha and anti-IFN-omega autoantibodies in the patient (not in the daughter), even 6 months after thymectomy (Figure 2D).