Good's syndrome or thymoma-associated immunodeficiency is a rare clinical entity that is often presumed to be common variable immunodeficiency, due to lack of awareness and recognition of this syndrome. This syndrome more often goes unrecognized if a thymoma is not detected. An appropriate immunological work-up that aids timely diagnosis and adequate therapy with antimicrobials and intravenous immunoglobulins are mandatory to prevent the long-term complications and mortality associated with this syndrome. We present the clinical and immunological profile of a young man with Good's syndrome that was initially presumed to be common variable immunodeficiency.

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BACKGROUND Acute exacerbation of chronic obstructive pulmonary disease (AECOPD) carries a significant morbidity and mortality with a need for frequent hospitalizations and mechanical ventilation. Thus, a model was searched that required simple information that was consistently available in emergency department, upon the presentation of the patient which allowed risk stratification and to identify patients who might potentially benefit from early intervention. METHODS This was a prospective observational study conducted over a period of 6 months, from May 2018 to December 2018 with a study sample of 136 patients. The primary objective was aimed to validate the BAP-65 score system in predicting the need for ventilatory support and mortality in patients who presented with acute exacerbation of COPD. RESULTS Mean age of the study population was 64.13 ± 9.7 and 29 (21.32 %) were females with obvious male predominance. It was observed that as the BAP-65 score increases, the mortality increases. Mortality among the score groups 0, 1 and 2 was one, zero, one respectively. The mortality is about 37.5 % in the score group 3 and it increased to 90.9 % in the score group 4. The patients who needed mechanical ventilation were about 4 % in the score group 2 and it increased to 100 % in the score group 4. BAP-65 scoring system had a sensitivity of 88.89 % and specificity of 90.68 % in predicting the in-hospital mortality, and a sensitivity of 84 % and specificity of 94.59 % in predicting the need for mechanical ventilation during hospital stay. CONCLUSIONS The BAP-65 scoring system seems to be a promising tool which is simple and accurate. The score correlated well with both the mortality and also the need for mechanical ventilation, thus helping in decision making at triage level and also in prognostication of the disease. KEYWORDS Chronic Obstructive Pulmonary Disease, Acute Exacerbation, BAP-65, AECOPD, Mortality, Mechanical Ventilation