Severe Paradoxical Reaction During Treatment of Disseminated Tuberculosis in a Patient With Neutralizing Anti-IFNγ Autoantibodies

Clin Infect Dis. 2016 Mar 15;62(6):770-773. doi: 10.1093/cid/civ995. Epub 2015 Dec 8.

Abstract

Interferon-gamma (IFNγ) neutralizing autoantibodies are associated with disseminated nontuberculous mycobacterial infections. We report a previously healthy Thai woman with disseminated tuberculosis and high-titer IFNγ-neutralizing autoantibodies, who developed a severe inflammatory reaction during anti-tuberculosis treatment. IFNγ contributes to host control of tuberculosis but appears inessential for tuberculosis paradoxical reactions.

Keywords: IRIS; autoantibodies; disseminated tuberculosis; interferon-gamma; paradoxical reaction.

Publication types

  • Case Reports
  • Research Support, N.I.H., Intramural

MeSH terms

  • Anti-Bacterial Agents / administration & dosage
  • Anti-Bacterial Agents / adverse effects*
  • Antibodies, Neutralizing / biosynthesis*
  • Autoantibodies / blood*
  • Autoantibodies / immunology
  • Female
  • Humans
  • Immunoglobulin G / immunology
  • Inflammation / immunology
  • Inflammation / microbiology
  • Interferon-gamma / blood
  • Interferon-gamma / immunology*
  • Middle Aged
  • Tuberculosis, Miliary / drug therapy
  • Tuberculosis, Miliary / ethnology
  • Tuberculosis, Miliary / immunology*
  • United States

Substances

  • Anti-Bacterial Agents
  • Antibodies, Neutralizing
  • Autoantibodies
  • Immunoglobulin G
  • Interferon-gamma