title: Autoantibodies to interferon-gamma in a patient with selective susceptibility to mycobacterial infection and organ-specific autoimmunity.
abstract: We evaluated a patient with disseminated Mycobacterium tuberculosis and Mycobacterium chelonae infection, of which he died. He also developed autoimmune (type I) diabetes and primary hypothyroidism. His serum contained a high titer of immunoglobulin G autoantibody to interferon-gamma (IFN-gamma) capable of blocking in vitro responses to this cytokine by peripheral blood mononuclear cells from normal donors. These results suggest that autoantibodies to IFN-gamma can induce susceptibility to disseminated mycobacterial infection, which may be refractory to chemotherapy.
authors.affiliation: Department of Clinical Immunology and Biochemistry, Addenbrooke's Hospital, Cambridge, United Kingdom. rd270@cam.ac.uk
authors.forename: Rainer
authors.initials: R
authors.lastname: Döffinger
authors.forename: Matthew R
authors.initials: MR
authors.lastname: Helbert
authors.forename: Gabriela
authors.initials: G
authors.lastname: Barcenas-Morales
authors.forename: Kun
authors.initials: K
authors.lastname: Yang
authors.forename: Stephanie
authors.initials: S
authors.lastname: Dupuis
authors.forename: Lourdes
authors.initials: L
authors.lastname: Ceron-Gutierrez
authors.forename: Clara
authors.initials: C
authors.lastname: Espitia-Pinzon
authors.forename: Neil
authors.initials: N
authors.lastname: Barnes
authors.forename: Graham
authors.initials: G
authors.lastname: Bothamley
authors.forename: Jean-Laurent
authors.initials: JL
authors.lastname: Casanova
authors.forename: Hilary J
authors.initials: HJ
authors.lastname: Longhurst
authors.forename: Dinakantha S
authors.initials: DS
authors.lastname: Kumararatne
mesh_terms: D001323:Autoantibodies / Q000097:blood*; D015551:Autoimmunity; D003922:Diabetes Mellitus, Type 1 / Q000209:etiology; D004198:Disease Susceptibility; D006801:Humans; D007037:Hypothyroidism / Q000209:etiology; D007074:Immunoglobulin G / Q000097:blood*; D007371:Interferon-gamma / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D009165:Mycobacterium Infections, Nontuberculous / Q000150:complications / Q000276:immunology*; D016926:Mycobacterium chelonae / Q000187:drug effects; D009169:Mycobacterium tuberculosis / Q000187:drug effects; D014376:Tuberculosis / Q000150:complications / Q000276:immunology*
chemical_list: D001323:Autoantibodies; D007074:Immunoglobulin G; D007371:Interferon-gamma