Saleem Nasir, Saba Raya, Maddika Srikanth, Weinstein Mitchell
Infectious Diseases Section, Department of Internal Medicine, Presence Saint Joseph Hospital, Chicago, Illinois.
Infectious Diseases Section, Department of Internal Medicine, Presence Saint Joseph Hospital, Chicago, Illinois.
Am J Med Sci. 2017 Apr;353(4):394-397. doi: 10.1016/j.amjms.2016.03.001. Epub 2016 Mar 14.
Mycobacterium kansasii, a nontuberculous mycobacterium, can lead to lung disease similar to tuberculosis. Immunotherapeutic biologic agents predispose to infections with mycobacteria, including M kansasii. T-cell-mediated interferon gamma release assays like QuantiFERON-TB Gold Test (QFT) are widely used by clinicians for the diagnosis of infections with Mycobacterium tuberculosis; however, QFT may also show positive result with certain nontuberculous mycobacterial infections. We report a case of M kansasii pulmonary infection, with a positive QFT, in an immunocompromised patient receiving prednisone, leflunomide and tocilizumab, a humanized anti-interleukin-6 receptor monoclonal antibody. This case highlights the risk of mycobacterial infections with the use of various biologic agents and the need for caution when interpreting the results of interferon gamma release assays.
堪萨斯分枝杆菌是一种非结核分枝杆菌，可导致类似于结核病的肺部疾病。免疫治疗生物制剂易引发分枝杆菌感染，包括堪萨斯分枝杆菌。像结核感染T细胞检测（QFT）这样的T细胞介导的干扰素γ释放试验被临床医生广泛用于诊断结核分枝杆菌感染；然而，QFT在某些非结核分枝杆菌感染中也可能呈阳性结果。我们报告了一例在接受泼尼松、来氟米特和托珠单抗（一种人源化抗白细胞介素-6受体单克隆抗体）治疗的免疫功能低下患者中，出现QFT阳性的堪萨斯分枝杆菌肺部感染病例。该病例凸显了使用各种生物制剂时发生分枝杆菌感染的风险，以及在解释干扰素γ释放试验结果时需谨慎的必要性。
