We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
Late-Onset Disseminated Mycobacterium avium intracellulare Complex Infection (MAC), Cerebral Toxoplasmosis and Salmonella Sepsis in a German Caucasian Patient with Unusual Anti-Interferon-Gamma IgG Autoantibodies.
- Authors
Hanitsch, Leif; Löbel, Madlen; Müller-Redetzky, Holger; Schürmann, Mariana; Suttorp, Norbert; Unterwalder, Nadine; Mönnich, Ulrike; Meisel, Christian; Wittke, Kirsten; Volk, Hans-Dieter; Scheibenbogen, Carmen; Kölsch, Uwe
- Abstract
Purpose: Since we described for the first time a patient with IgG autoantibodies to IFN-γ more than 10 years ago, many patients with IFN-γ IgG autoantibodies have been described, mostly in Mongolian/ Asian patients with a particular HLA background and in association with disseminated nontuberculous mycobacterial infections. Very recently, the first Caucasian US patient was reported and we now present the case of a 65-year old Caucasian woman with severe disseminated Mycobacterium avium infection, cerebral toxoplasmosis and salmonella sepsis who was tested positive for IFN-γ deficiency due to unusual anti-IFN-γ IgG autoantibodies. Methods: IFN-γ production after ex vivo ConA stimulation of the patient's whole blood and isolated peripheral blood mononuclear cells was assessed. Anti-human IFN-γ antibodies were measured by Ig/Ig-subclass-specific ELISA. In vitro physiologic relevance and blocking capacity of IFN-γ-stimulation by patient's serum was analysed by flow cytometric assessment of cytokine-induced phosphorylation of pSTAT1. Results: Severely impaired IFN-γ production in the patient's whole blood but normal production in peripheral blood mononuclear cells in the absence of autologous serum was observed. High titre anti-IFN-γ antibodies of the IgG subclass could be demonstrated in the patient's serum by ELISA. Further, the addition of patient's serum to IFN-γ-stimulated immune cells showed inhibition of STAT1 phosphorylation. Conclusions: IFN-γ autoantibodies of any IgG-isotype should be considered in patients with severe opportunistic infections independent of age at onset and ethnicity.
- Subjects
TOXOPLASMOSIS; MYCOBACTERIUM avium; INTERFERONS; AUTOANTIBODIES; IMMUNOGLOBULIN G; CYTOKINES
- Publication
Journal of Clinical Immunology, 2015, Vol 35, Issue 4, p361
- ISSN
0271-9142
- Publication type
Article
- DOI
10.1007/s10875-015-0161-5