An Ran, Liu Zhiyin, Luo Fangxiu, Yan Zeying, Wang Ying, Sun Haimin, Tian Jie, Chen Yu, Chen Yubao
Department of Hematology, Ruijin Hospital Shanghai Jiao Tong University School of Medicine Shanghai China.
Department of Pathology, Ruijin Hospital Shanghai Jiao Tong University School of Medicine Shanghai China.
Clin Case Rep. 2024 Sep 18;12(9):e9446. doi: 10.1002/ccr3.9446. eCollection 2024 Sep.
Adult-onset immunodeficiency (AOID) is an emerging acquired immunodeficiency, characterized by multiple opportunistic infections including non-tuberculous mycobacterium (NTM) due to the presence of anti-IFN-γ autoantibody (AIGA). This case highlights the challenges of accurate diagnosis of monoclonal gammaglobulinemia with NTM infection and favorable outcomes of anti-plasma cell therapy in AOID.
Adult-onset immunodeficiency (AOID) is an emerging acquired immunodeficiency due to anti-IFN-γ autoantibody (AIGA) with low morbidity, frequent disseminated infections, a prolonged course, difficult diagnosis and treatment, and a poor prognosis. Here, we report a patient with positive AIGA and monoclonal gammaglobulinemia who was mimicking symptomatic multiple myeloma and resulting in a non-tuberculous mycobacterial (NTM) infection. While he achieved an excellent therapeutic effect with anti-plasma cell therapy, it also serves as a warning that monoclonal gammaglobulinemia with NTM infection is easily misdiagnosed as symptomatic multiple myeloma, and the screening for AIGA should not be ignored in patients with NTM infection.
成人起病型免疫缺陷（AOID）是一种新出现的获得性免疫缺陷，其特征为存在抗干扰素-γ自身抗体（AIGA）导致包括非结核分枝杆菌（NTM）在内的多种机会性感染。该病例凸显了NTM感染合并单克隆丙种球蛋白血症准确诊断的挑战以及AOID中抗浆细胞治疗的良好预后。
成人起病型免疫缺陷（AOID）是一种因抗干扰素-γ自身抗体（AIGA）引起的新出现的获得性免疫缺陷，发病率低，感染常播散，病程迁延，诊断和治疗困难，预后不良。在此，我们报告1例AIGA阳性且患有单克隆丙种球蛋白血症的患者，该患者表现类似有症状的多发性骨髓瘤并导致非结核分枝杆菌（NTM）感染。虽然他接受抗浆细胞治疗取得了良好疗效，但这也警示NTM感染合并单克隆丙种球蛋白血症易被误诊为有症状的多发性骨髓瘤，对于NTM感染患者不应忽视AIGA筛查。
