Non-tuberculous mycobacterial infection and reactive dermatosis associated with adult-onset immunodeficiency due to anti–interferon-gamma autoantibodies: A case report. Issue 36 (4th September 2020)

• Record Type: Journal Article
• Authors: Liang, Xiao-Na; Bin, Yan-Fei; Lai, Guan-Ting; Li, Ying-Hua; Zhang, Jian-Quan; Zhong, Xiao-Ning; Bai, Jing; Li, Mei-Hua; Deng, Jing-Min; He, Zhi-Yi
• Other Names: Saranathan. Maya section editor.
• Is Part Of: Medicine. Volume 99:Issue 36(2020)
• Publication Date: 2020-09-04
• Subjects: anti–interferon-gamma autoantibody -- non-tuberculous mycobacterial infection -- reactive dermatosis; Medicine -- Periodicals; Medicine -- Periodicals; Médecine -- Périodiques; Geneeskunde; Medicine; Periodicals; Periodicals; 610.5
• DOI: 10.1097/MD.0000000000021738
• Languages: English
• ISSNs: 0025-7974

Abstract

Abstract: Introduction: Anti–interferon-gamma (anti–IFN-γ) autoantibody increases susceptibility to lower-virulence pathogens and causes immunodeficiency syndrome in HIV–negative patients. Patient concerns: A 69-year-old Chinese man presented with a 2-month history of pruritic skin lesions on his forearms, trunk, and legs. He was diagnosed with 5 opportunistic infections without conventional immunosuppression-associated factors in past. The most conspicuous characteristics were recurrent pulmonary infection, persistent immunoglobulin E elevation and eosinophilia during the whole disease course. Diagnosis: Enzyme-linked immunosorbent assay showed anti–IFN-γ autoantibody positive. The final diagnosis for the patient was adult-onset immunodeficiency due to anti–IFN-γ autoantibody, non-tuberculous mycobacterial (NTM) infection and reactive dermatosis. Interventions: The patient underwent long-term anti-NTM and corticosteroid maintenance treatment. Outcomes: The patient was followed for 2 years during which opportunistic infection no longer happened, the immunoglobulin E level and eosinophil count reduced, the autoantibody levels remained largely steady and lung lesions absorbed. Conclusion: Clinicians should be vigilant for NTM infection in patients with anti–IFN-γ autoantibodies, even when culture results are negative. Long-term anti–non-tuberculous mycobacteria and glucocorticoid regimens were effective. Abstract : Supplemental Digital Content is available in the text