Otome O, O'Reilly M, Lim L
Department of Infectious Diseases, Box Hill Hospital, Eastern Health, Melbourne, Victoria, Australia.
Intern Med J. 2015 Oct;45(10):1073-6. doi: 10.1111/imj.12875.
Disseminated non-tuberculous mycobacterial (NTM) infection is rare in immunocompetent adults. Anti-interferon-gamma (IFN-γ) autoantibodies have recently been associated with NTM infections, particularly in patients of Asian ethnicity. We describe a case of disseminated Mycobacterium haemophilum skeletal infection due to anti IFN-γ autoantibodies in a 71-year-old Cambodian man. He responded to a combination of anti-mycobacterial antibiotics without requirement for immunomodulator therapy. Testing for acquired IFN-γ deficiency due to IFN-γ autoantibodies should be considered when standard tests for immunodeficiency are negative in patients with unusual or severe opportunistic infections, including NTM.
播散性非结核分枝杆菌（NTM）感染在免疫功能正常的成年人中较为罕见。抗干扰素-γ（IFN-γ）自身抗体最近被认为与NTM感染有关，尤其是在亚洲种族患者中。我们报告了一例71岁柬埔寨男性因抗IFN-γ自身抗体导致播散性嗜血性分枝杆菌骨骼感染的病例。他对抗分枝杆菌抗生素联合治疗有反应，无需免疫调节剂治疗。对于患有不寻常或严重机会性感染（包括NTM）且免疫缺陷标准检测为阴性的患者，应考虑检测是否因IFN-γ自身抗体导致获得性IFN-γ缺乏。
