title: [Recurrent atypical mycobacterial infections in the adult: think of autoantibodies against interferon-gamma !].
abstract: BACKGROUND
  Disseminated non-tuberculosis mycobacterial infections are associated with a defect of the cellular immune response. They have been mainly reported in AIDS patients. Cases related to the presence of anti-interferon-γ autoantibodies are rare.
  
  
  METHODS
  We report a non HIV-infected 45-year-old Thai woman, with a past medical history of Graves' disease. She presented with recurrent disseminated and severe non-tuberculous mycobacterial infections that were related to the production of anti-interferon-γ autoantibody. The diagnosis was suspected in the presence of a negative interferon-γ release assay (IGRA) including with the positive control, and evidenced by the identification of specific antibodies.
  
  
  CONCLUSIONS
  Anti-interferon-γ autoantibody production is a rare cause of non tuberculous mycobacterial infection. Such a mechanism should be suspected in non HIV-infected patients and especially in those having an Asiatic ethnicity or an associated immune disorder. A negative IGRA (including with the positive control) is a reliable diagnostic tool and should be completed with the identification of specific autoantibodies.
authors.affiliation: Département d'infectiologie, CHU de Dijon, 2, boulevard du Maréchal-de-Lattre-de-Tassigny, 21079 Dijon cedex, France.
authors.forename: J-B
authors.initials: JB
authors.lastname: Picque
authors.forename: M
authors.initials: M
authors.lastname: Blot
authors.forename: R
authors.initials: R
authors.lastname: Binois
authors.forename: G
authors.initials: G
authors.lastname: Jeudy
authors.forename: A-L
authors.initials: AL
authors.lastname: Simonet
authors.forename: J
authors.initials: J
authors.lastname: Cagnon
authors.forename: S
authors.initials: S
authors.lastname: Mahy
authors.forename: M
authors.initials: M
authors.lastname: Duong
authors.forename: M
authors.initials: M
authors.lastname: Buisson
authors.forename: P
authors.initials: P
authors.lastname: Chavanet
authors.forename: L
authors.initials: L
authors.lastname: Piroth
mesh_terms: D001323:Autoantibodies / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D003937:Diagnosis, Differential; D005260:Female; D006111:Graves Disease / Q000150:complications*; D006801:Humans; D016867:Immunocompromised Host; D007371:Interferon-gamma / Q000276:immunology*; D059425:Interferon-gamma Release Tests; D008875:Middle Aged; D009165:Mycobacterium Infections, Nontuberculous / Q000150:complications / Q000175:diagnosis / Q000276:immunology*; D009170:Nontuberculous Mycobacteria / Q000302:isolation & purification; D012008:Recurrence; D012720:Severity of Illness Index
chemical_list: D001323:Autoantibodies; D015415:Biomarkers; D007371:Interferon-gamma