University of Arkansas for Medical Sciences, Little Rock, AR, USA.
J Investig Med High Impact Case Rep. 2021 Jan-Dec;9:2324709621990771. doi: 10.1177/2324709621990771.
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.
针对干扰素 γ 的自身抗体是人体免疫反应第一道防线的一部分，在未感染 HIV 的成年人中构成一种罕见的获得性免疫缺陷形式，可导致播散性非典型分枝杆菌感染。特别是在东南亚血统的人群中已有描述。在本病例报告中，我们描述了一位先前健康的老挝男性，其皮肤病变符合 Sweet 综合征，后来发现是由播散性非典型分枝杆菌病引发的。广泛的免疫学检查显示患者存在针对干扰素 γ 的自身抗体，使他易感染这种感染。我们的报告展示了一个具有多层次诊断的复杂病例，同时邀请了多个专业领域的观点。这个神秘的病例强调了在治疗某些固有耐药的非典型感染时，需要进行广泛的鉴别诊断，并特别注意人群特征的重要性。
