PDF(Pubmed)
Abstract：
BACKGROUND: Autoantibodies against interferon-γ (IFN-γ) can inhibit IFN-γ-dependent signal transducer and activator of transcription 1 phosphorylation and thus increase the risk of infection with intracellular pathogens, such as Talaromyces marneffei (TM), nontuberculous mycobacteria (NTMs), and Mycobacterium tuberculosis (TB). Here, we report a rare case of triple infection caused by TM, NTM, and TB in a human immunodeficiency virus-negative patient.
METHODS: A middle-aged female was admitted to our hospital after experiencing recurrent rash, cough, and expectoration for 4 months. She was successively diagnosed with NTM, TM, and TB infections without conventional immunosuppression-associated factors. However, after effective anti-infective treatment, the patient was confirmed to have allergic conjunctivitis and was successfully treated with corticosteroids and immunosuppressants. The most conspicuous characteristics were recurrent infection and immune disorders.
CONCLUSIONS: High-titer anti-IFN-γ autoantibodies are strongly associated with severe and disseminated infections, such as NTM, TM, and TB. It is characterized by persistently high degree of inflammation and high immunoglobin levels.
METHODS: A middle-aged female was admitted to our hospital after experiencing recurrent rash, cough, and expectoration for 4 months. She was successively diagnosed with NTM, TM, and TB infections without conventional immunosuppression-associated factors. However, after effective anti-infective treatment, the patient was confirmed to have allergic conjunctivitis and was successfully treated with corticosteroids and immunosuppressants. The most conspicuous characteristics were recurrent infection and immune disorders.
CONCLUSIONS: High-titer anti-IFN-γ autoantibodies are strongly associated with severe and disseminated infections, such as NTM, TM, and TB. It is characterized by persistently high degree of inflammation and high immunoglobin levels.
摘要：
背景：针对干扰素-γ（IFN-γ）的自身抗体可以抑制IFN-γ依赖性信号转导和转录激活因子1的磷酸化，从而增加被细胞内病原体感染的风险，例如马尔尼菲塔拉酵母(TM)，非结核分枝杆菌（NTM），和结核分枝杆菌（TB）。这里,我们报道了一例罕见的由TM引起的三重感染病例，NTM,人类免疫缺陷病毒阴性患者的结核病。
方法：一名中年女性因反复皮疹入院，咳嗽,并咳痰4个月。她先后被诊断出患有NTM，TM,和没有常规免疫抑制相关因素的结核病感染。然而,经过有效的抗感染治疗，患者被证实患有过敏性结膜炎，并成功使用皮质类固醇和免疫抑制剂治疗。最明显的特征是反复感染和免疫紊乱。
结论：高滴度抗IFN-γ自身抗体与严重和播散性感染密切相关，例如NTM，TM,和TB。其特征在于持续高度的炎症和高免疫球蛋白水平。
方法：一名中年女性因反复皮疹入院，咳嗽,并咳痰4个月。她先后被诊断出患有NTM，TM,和没有常规免疫抑制相关因素的结核病感染。然而,经过有效的抗感染治疗，患者被证实患有过敏性结膜炎，并成功使用皮质类固醇和免疫抑制剂治疗。最明显的特征是反复感染和免疫紊乱。
结论：高滴度抗IFN-γ自身抗体与严重和播散性感染密切相关，例如NTM，TM,和TB。其特征在于持续高度的炎症和高免疫球蛋白水平。
