Department of Hematology and Clinical Immunology, Yokohama City University School of Medicine, Japan.
Infection Prevention and Control Department, Yokohama City University Hospital, Japan.
Intern Med. 2022 Aug 1;61(15):2377-2385. doi: 10.2169/internalmedicine.8366-21. Epub 2022 Jan 13.
Disseminated nontuberculous mycobacterial infection (DNTM) is typically observed in immunocompromised hosts. Recently, it has been reported that healthy individuals with serum neutralizing autoantibodies for interferon (IFN)-γ can also develop DNTM. We herein report a case of anti-IFN-γ antibody-seropositive DNTM caused by Mycobacterium kansasii with symptoms mimicking TAFRO or POEMS syndrome, including anasarca, organomegaly, skin pigmentation, polyneuropathy, osteosclerotic change, thrombocytopenia, serum M protein, high C-reactive protein level, and reticulin fibrosis. The combination of antimicrobial chemotherapy with glucocorticoid and intravenous immunoglobulin improved his symptoms. Glucocorticoids may be an effective method of suppressing the production of anti-IFN-γ antibodies in DNTM.
播散性非结核分枝杆菌感染（DNTM）通常发生在免疫功能低下的宿主中。最近有报道称，具有血清中和干扰素（IFN）-γ自身抗体的健康个体也可能发生 DNTM。本文报告了一例由堪萨斯分枝杆菌引起的抗 IFN-γ 抗体阳性 DNTM 病例，其症状类似于 TAFRO 或 POEMS 综合征，包括水肿、器官肿大、皮肤色素沉着、多发性神经病、骨质硬化性改变、血小板减少、血清 M 蛋白、高 C 反应蛋白水平和网状纤维纤维化。抗菌化疗联合糖皮质激素和静脉注射免疫球蛋白改善了他的症状。糖皮质激素可能是抑制 DNTM 中抗 IFN-γ 抗体产生的有效方法。
