Multiple intracellular pathogen infections with ocular immune damage associated with adult-onset immunodeficiency due to anti-interferon-γ autoantibodies: A case report

Abstract

Background: Autoantibodies to interferon-γ（IFN-γ）can inhibit IFN-γ-dependent signal transducer and activator of transcription (STAT)1 phosphorylation thus predispose those patients with susceptibility to infections with normally considered low virulence pathogens, such as Talaromyces marneffei (TM), nontuberculous mycobacteria（NTM）and Mycobacterium tuberculosis. [1][2]But they are not as commonly associated with TM and NTM co-infected with Mycobacterium tuberculosis. Case presentation: Herein, we report a case of a middle-aged woman with a history of recurrent rash, cough, and expectoration. She was successively diagnosed with NTM, TM, and Mycobacterium tuberculosis infection and allergic conjunctivitis without conventional immunosuppression-associated factors in the past. The most conspicuous characteristics were recurrent infection and immune compromission. Conclusions: High-titer anti-IFN-γ autoantibodies (AIGAs) are strongly associated with severe and disseminated infections, such as NTM, TM and Mycobacterium tuberculosis. It is characterized by persistently elevated levels of inflammation and immunoglobin.