[DISSEMINATED NONTUBERCULOUS MYCOBACTERIOSIS THAT IS POSITIVE FOR NEUTRALIZING ANTI-INTERFERON-GAMMA AUTOANTIBODIES: A NEW DISEASE CONCEPT BASED ON HOST FACTORS].

Abstract

Disseminated nontuberculous mycobacteriosis (NTM infection) is a disease that causes multiple organ lesions and occurs against an immunodeficiency background. Several host factors for this disease have been identified. Recently, neutralizing anti-interferon-γ autoantibodies (IFN-γ Ab) have been detected in some cases of disseminated NTM infection that had no previously known immunodeficiency, garnering attention as a new form of acquired immunodeficiency. We previously reported on methods for detecting IFN-γ Ab in clinical specimens as part of the diagnostic process that are being used to evaluate suspected cases at various institutions. Overseas reports of positive results were achieved by administration of the anti-CD20 antibody rituximab in addition to antibacterial chemotherapy in cases of intractable disseminated NTM infection that tested positive for IFN-γ Ab. This highlights the importance of diagnosis as well. Clinicians should consider the existence of this pathology. Although many host factors for NTM infection have yet to be identified, IFN-γ Ab positivity should be investigated further as a new disease concept, not only for its pathological dimensions but also from the standpoint of treatment strategies. In the future, more cases need to be examined and analyzed to obtain further epidemiological and pathological findings.