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高滴度抗 IFN-γ 自身抗体患者伴眼部病变的多种病原体感染:病例报告。

Multiple pathogen infections accompanied with ocular pathologies in a patient with high-titer Anti-IFN-γ autoantibodies: a case report.

机构信息

Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Guangxi Medical University, Guangxi Zhuang Autonomous Region, No. 6 Shuangyong Road, Nanning, Guangxi Zhuang Autonomous Region, 530021, P.R. China.

Department of Ophthalmology, The First Affiliated Hospital of Guangxi Medical University, Guangxi Zhuang Autonomous Region, No. 6 Shuangyong Road, Nanning, Guangxi Zhuang Autonomous Region, 530021, P.R. China.

出版信息

BMC Infect Dis. 2024 Nov 19;24(1):1319. doi: 10.1186/s12879-024-10217-2.

Abstract

The typical clinical characteristic of patients with anti-IFN-γ autoantibodies (AIGAs) is primarily associated with infection caused by intracellular pathogens. With continued research, additional clinical characteristics have been gradually uncovered. Here, we present a case of multiple pathogen infections accompanied by ocular pathologies in a patient with high titers of AIGAs. The patient, a 53-year-old female patient, was admitted to our hospital after finding a mass in the right supraclavicular fossa. She was successively diagnosed with Talaromyces marneffei, Aspergillus flavus and Nontuberculous mycobacteria (NTM) infections. Then, she received a complete course of antifungal agents for nearly 3.5 years and anti-NTM treatment for nearly 3 years, with discontinuation upon symptom improvement. However, there was a rapid recurrence of the infection upon cessation of the drug despite improvement in the patient's symptoms. Moreover, when the recurrent infection stabilized, the patient exhibited immune conjunctivitis and dry eye, which was successfully treated by tacrolimus eye drops and lubricant. Patients with high-titer AIGAs are more prone to experiencing recurrence and/or persistent infection, as well as immune disorders.

摘要

抗 IFN-γ 自身抗体(AIGAs)患者的典型临床特征主要与细胞内病原体感染有关。随着研究的不断深入,逐渐发现了其他一些临床特征。在此,我们报告了一例 AIGAs 滴度高的患者合并多种病原体感染和眼部病变。该患者为 53 岁女性,因右锁骨上窝发现肿块而就诊于我院。她先后被诊断为马尔尼菲青霉、黄曲霉菌和非结核分枝杆菌(NTM)感染。随后,她接受了近 3.5 年的抗真菌药物治疗和近 3 年的抗 NTM 治疗,症状改善后停药。然而,尽管患者症状改善,停药后感染仍迅速复发。此外,当复发性感染稳定时,患者出现免疫性结膜炎和干眼症,经他克莫司滴眼液和润滑剂滴眼治疗后成功治愈。高滴度 AIGAs 的患者更容易出现复发和/或持续性感染以及免疫紊乱。

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