DeLeon Thomas T, Chung Heath H, Opal Steven M, Dworkin Jonathan D
Internal Medicine Residency Program, John A. Burns School of Medicine, University of Hawai'i, Honolulu, HI (TTD).
Hawaii J Med Public Health. 2014 Sep;73(9 Suppl 1):15-7.
Interferon gamma (IFN-γ) autoantibodies are a relatively recently discovered clinical entity, which have been shown to be associated with disseminated non-tuberculous mycobacterial (NTM) infections and other opportunistic infections. Interestingly, isolated NTM infections (without disseminated NTM infection) have not been shown to be a good predictor of the presence of IFN-γ autoantibodies. This case describes an isolated NTM empyema in a patient with IFN-γ autoantibodies and makes the argument that the development of an NTM empyema in a patient with no known immunodeficiency should prompt consideration for IFN-γ testing. Additionally, this case underscores the importance for clinicians to recognize that an unusual infection without the typical cause of impairment in immunity should prompt a more thorough investigation of the patient's immune system.
干扰素γ(IFN-γ)自身抗体是一种相对较新发现的临床实体,已被证明与播散性非结核分枝杆菌(NTM)感染及其他机会性感染有关。有趣的是,单纯的NTM感染(无播散性NTM感染)尚未被证明是IFN-γ自身抗体存在的良好预测指标。本病例描述了一名患有IFN-γ自身抗体的患者发生的单纯NTM脓胸,并提出在无已知免疫缺陷的患者中发生NTM脓胸应促使考虑进行IFN-γ检测。此外,本病例强调了临床医生认识到无典型免疫受损原因的不寻常感染应促使对患者免疫系统进行更全面调查的重要性。