Anti-interferon-γ Antibody-seropositive Disseminated Nontuberculous Mycobacterial Infection Mimicking POEMS and TAFRO Syndromes

Intern Med. 2022 Aug 1;61(15):2377-2385. doi: 10.2169/internalmedicine.8366-21. Epub 2022 Jan 13.

Abstract

Disseminated nontuberculous mycobacterial infection (DNTM) is typically observed in immunocompromised hosts. Recently, it has been reported that healthy individuals with serum neutralizing autoantibodies for interferon (IFN)-γ can also develop DNTM. We herein report a case of anti-IFN-γ antibody-seropositive DNTM caused by Mycobacterium kansasii with symptoms mimicking TAFRO or POEMS syndrome, including anasarca, organomegaly, skin pigmentation, polyneuropathy, osteosclerotic change, thrombocytopenia, serum M protein, high C-reactive protein level, and reticulin fibrosis. The combination of antimicrobial chemotherapy with glucocorticoid and intravenous immunoglobulin improved his symptoms. Glucocorticoids may be an effective method of suppressing the production of anti-IFN-γ antibodies in DNTM.

Keywords: Mycobacterium kansasii; POEMS syndrome; TAFRO syndrome; anti-interferon-γ antibody; disseminated nontuberculous mycobacterial infection.

Publication types

  • Case Reports

MeSH terms

  • Autoantibodies
  • Castleman Disease*
  • Humans
  • Interferon-gamma
  • Mycobacterium Infections, Nontuberculous* / diagnosis
  • Mycobacterium Infections, Nontuberculous* / drug therapy
  • Opportunistic Infections*

Substances

  • Autoantibodies
  • Interferon-gamma

Supplementary concepts

  • Multi-centric Castleman's Disease