title: A non-HIV case with disseminated Mycobacterium kansasii disease associated with strong neutralizing autoantibody to interferon-γ.
abstract: Disseminated non-tuberculous mycobacterium (dNTM) infection is rare in humans without human immunodeficiency virus (HIV) infection. Previous reports have shown autoantibodies to human interferon-gamma (IFN-γ), which play important roles in mycobacterium infection, in the sera of patients with non-HIV dNTM disease. Herein, we describe a 53-year-old male who was strongly suspected to have multicentric Castleman disease (MCD) based on bone marrow study and chest radiological findings. However, Mycobacterium kansasii was detected in respiratory samples including pleural effusion. We initiated anti-mycobacterial therapy under intensive care; he died on the 48(th) hospital day. We detected no hematological disorders, ruling out MCD postmortem. However, we detected M. kansasii in pulmonary, liver, spleen and bone marrow tissues. Moreover, anti-IFN-γ autoantibody was detected with strong neutralizing capacity for IFN-γ. We consider our present report to contribute to understanding of the relationship between anti-IFN-γ autoantibody and disease development.
authors.affiliation: Division of Intensive Care and Cardiac Care, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8603, Japan ; Department of Internal Medicine, Division of Respiratory Medicine, Infection and Oncology, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8603, Japan.
authors.forename: Takahito
authors.initials: T
authors.lastname: Nei
authors.affiliation: Department of Internal Medicine, Division of Hematology, Gastroenterology and Endocrinology and Metabolism, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8603, Japan.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Okabe
authors.affiliation: Department of Surgery, Division of Thoracic Surgery, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8603, Japan.
authors.forename: Iwao
authors.initials: I
authors.lastname: Mikami
authors.affiliation: Division of Intensive Care and Cardiac Care, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8603, Japan.
authors.forename: Yumika
authors.initials: Y
authors.lastname: Koizumi
authors.affiliation: Division of Intensive Care and Cardiac Care, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8603, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Mase
authors.affiliation: Department of Internal Medicine, Division of Respiratory Medicine, Infection and Oncology, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8603, Japan.
authors.forename: Kuniko
authors.initials: K
authors.lastname: Matsuda
authors.affiliation: Division of Intensive Care and Cardiac Care, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8603, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Yamamoto
authors.affiliation: Division of Intensive Care and Cardiac Care, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8603, Japan.
authors.forename: Shinhiro
authors.initials: S
authors.lastname: Takeda
authors.affiliation: Division of Intensive Care and Cardiac Care, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8603, Japan.
authors.forename: Keiji
authors.initials: K
authors.lastname: Tanaka
authors.affiliation: Department of Internal Medicine, Division of Hematology, Gastroenterology and Endocrinology and Metabolism, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8603, Japan.
authors.forename: Kazuo
authors.initials: K
authors.lastname: Dan
keywords: Anti-IFN-γ autoantibody; Disseminated non-tuberculous mycobacterium disease; Non-HIV patient