Disseminated Nontuberculous Mycobacterial Infection Associated With Acquired Immunodeficiency Due to Anti–Interferon γ Autoantibodies

Autoantibodies to interferon γ, part of the first line of defense in the human immune response, constitutes a rare form of an acquired immunodeficiency in HIV-uninfected adults that can predispose to disseminated atypical mycobacterial infection. Particularly, this has been described in people of Southeast Asian origin. In this case report, we describe a previously healthy, Laotian man who presented with skin lesions consistent with Sweet syndrome that were later found to be precipitated by disseminated atypical mycobacterial disease. Extensive immunological workup revealed the patient to have autoantibodies to interferon γ, rendering him susceptible to this infection. Our report demonstrates a complex case with a multilayered diagnosis, while inviting perspective from multiple specialties. This enigmatic case emphasizes the importance of a broad differential with special attention to demographics while demonstrating the difficulty in treating certain atypical infections that are inherently multidrug resistant.

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Interferon-γ Autoantibodies as Predisposing Factor for Nontuberculous Mycobacterial Infection

Emerging Infectious Diseases ◽

10.3201/eid2206.151860 ◽

2016 ◽

Vol 22 (6) ◽

pp. 1124-1126 ◽

Cited By ~ 21

Author(s):

Florent Valour ◽

Thomas Perpoint ◽

Agathe Sénéchal ◽

Xiao-Fei Kong ◽

Jacinta Bustamante ◽

...

Keyword(s):

Mycobacterial Infection ◽

Interferon Γ ◽

Predisposing Factor ◽

Nontuberculous Mycobacterial Infection

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Attenuation of Helper T Cell Capacity for TH1 and TH17 Differentiation in Children With Nontuberculous Mycobacterial Infection

The Journal of Infectious Diseases ◽

10.1093/infdis/jiz371 ◽

2019 ◽

Vol 220 (11) ◽

pp. 1843-1847

Author(s):

Tiffany A Claeys ◽

Oscar Rosas Mejia ◽

Samuel Marshall ◽

Jason A Jarzembowski ◽

Don Hayes ◽

...

Keyword(s):

Lymph Node ◽

Nontuberculous Mycobacteria ◽

Mycobacterial Infection ◽

Interferon Γ ◽

Interleukin 17 ◽

Th Cells ◽

Functional Assays ◽

Nontuberculous Mycobacterial Infection ◽

Community Controls ◽

Th17 Differentiation

Abstract Nontuberculous mycobacteria (NTM) infect children with increasing frequency worldwide. Using blood and lymph node tissue from children with NTM lymphadenitis, and uninfected lymph node tissue from community controls, we evaluated helper T (TH) cells in functional assays of TH1/TH17 differentiation and measured the concentration of their associated cytokines at the site of infection. Circulating TH cells from infected children were attenuated in their TH1/TH17 differentiation capacity and expressed less interferon γ and interleukin 17 after polyclonal stimulation. Similar differences were observed at the site of infection, where most cytokine concentrations were unchanged relative to controls. Our data are consistent with a model wherein TH1/TH17 differentiation is attenuated in NTM-infected children.

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