Abstract
ObjectivesMycobacterium avium complex pulmonary disease (MAC-PD) can be serologically diagnosed according to the presence of anti-glycopeptidolipid (GPL)-core IgA antibodies. However, few studies have examined the association between serum anti-GPL-core IgA antibody titers and the clinical characteristics of patients with MAC-PD. MethodsFrom April 2014 to June 2019, the levels of anti-GPL-core IgA antibodies in 489 MAC-PD patients were determined at the current institute. Of them, 89 patients fulfilled the criteria of the American Thoracic Society and the Infectious Diseases Society of America statement on the diagnosis, treatment, and prevention of nontuberculous mycobacterial diseases. Patients were categorized into the antibody strong-positive (n = 27), weak-positive (n = 32), and negative (n = 30) groups according to their serum anti-GPL-core IgA antibody results. Their clinical characteristics were retrospectively compared. ResultsDisease progression requiring treatment and extensive radiological findings were significantly abundant in the strong-positive group compared with the weak-positive group. Clinical characteristics of the antibody weak-positive and negative groups did not significantly differ. ConclusionsThe findings revealed that serum anti-GPL-core IgA antibody titers are useful for diagnosing MAC-PD and also for predicting the risk of exacerbation.
Highlights
The number of patients with Mycobacterium avium complex pulmonary disease (MAC-PD) is increasing globally (Prevots and Marras, 2015; Tan et al, 2018; Furuuchi et al, 2019; Kendall and Winthrop, 2013; Hoefsloot et al, 2013; Simons et al, 2011)
The findings revealed that serum anti-GPL-core IgA antibody titers are useful for diagnosing MAC-PD and for predicting the risk of exacerbation
119 newly diagnosed NTM-PD patients fulfilled the criteria of the American Thoracic Society (ATS) and the Infectious Disease Society of America (IDSA) statement on the diagnosis, treatment, and prevention of nontuberculous mycobacterial diseases (Daley et al, 2020; Griffith et al, 2007)
Summary
The number of patients with Mycobacterium avium complex pulmonary disease (MAC-PD) is increasing globally (Prevots and Marras, 2015; Tan et al, 2018; Furuuchi et al, 2019; Kendall and Winthrop, 2013; Hoefsloot et al, 2013; Simons et al, 2011). There is an increasing number of cases of women with MAC-PD, with central granular shadows of the middle lobe of the lung. MAC-PD may have poor airway symptoms and bronchoscopy may be essential for diagnosis because the causative bacteria are not always detected in sputum samples; it may be difficult to detect bacteria by bronchoscopy and some patients are hesitant to undergo the procedure. It is difficult to distinguish between colonization and contamination because MAC exists universally in soil, natural water, and tap water (Daley et al, 2020)
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