Refractory Mycobacterium avium Complex Pneumonia and Anti-Interferon-γ Autoantibodies

Abstract

Abstract There has been increasing evidence in recent literature of the link between acquired antibodies to cytokines and manifestations of immune deficiency, for example, the emerging association between acquired interferon gamma autoantibody and susceptibility to intracellular organisms, in particular, nontuberculous mycobacterium (NTM). Although the presence of these autoantibodies does not always reflect pathology, their presence in high titers in a healthy individual in the setting of an opportunistic infection necessitates greater research with regard to their role. We report a case of refractory NTM with herpes zoster reactivation in an adult South Asian woman developing in association with acquired interferon gamma autoantibody. Consider testing for this rare adult onset immunodeficiency and similar ones in the setting of severe refractory or disseminated NTM and other opportunistic pathogens in patients without human immunodeficiency virus infection or acquired immunodeficiency syndrome.