Disseminated tuberculosis, CMV viraemia & haemophagocytic-lymphohistiocystosis syndrome in an adult patient with anti- IFNγ autoantibodies - case report and brief review

G I Butel-Simoes; C Kiss; K Kong; L B Rosen; L M Hosking; S Barnes; G A Jenkin; S Megaloudis; B Kumar; S M Holland; S Ojaimi

doi:10.1016/j.clicom.2023.08.001

Disseminated tuberculosis, CMV viraemia & haemophagocytic-lymphohistiocystosis syndrome in an adult patient with anti- IFNγ autoantibodies - case report and brief review

Clin Immunol Commun. 2023 Dec 15:4:55-59. doi: 10.1016/j.clicom.2023.08.001. Epub 2023 Sep 1.

Authors

G I Butel-Simoes¹, C Kiss¹, K Kong¹, L B Rosen², L M Hosking^{3

4}, S Barnes^{5

6}, G A Jenkin¹, S Megaloudis⁷, B Kumar⁸, S M Holland², S Ojaimi^{1

5

9

10}

Affiliations

¹ Monash Infectious Diseases, Monash Health, Victoria, Australia.
² Immunopathogenesis Section, Laboratory of Clinical Immunology and Microbiology, National Institute of Allergy and Infectious Diseases, National Institute of Health, Bethesda, MD, United States.
³ Department of Allergy and Immunology, Royal Children's Hospital, Parkville, Victoria, Australia.
⁴ Immunology Laboratory, Laboratory Services, Royal Children's Hospital, Parkville, Victoria, Australia.
⁵ Monash Lung Sleep Allergy Immunology, Monash Health, Victoria, Australia.
⁶ Monash University Department of Medicine, Monash University, Victoria, Australia.
⁷ Haematology Laboratory, Monash Pathology, Monash Health, Victoria, Australia.
⁸ Anatomical Pathology Laboratory, Monash Pathology, Monash Health, Victoria, Australia.
⁹ Centre for Inflammatory Diseases, School of Clinical Sciences, Monash University, Victoria, Australia.
¹⁰ Immunology Laboratory, Monash Pathology, Monash Health, Victoria, Australia.

Abstract

We report a case of an adult female with disseminated tuberculosis, cytomegalovirus viraemia and haemophagocytic-lymphohistiocystosis syndrome associated with neutralizing anti- interferon gamma (IFNγ) autoantibodies demonstrated by absent IFNγ stimulated STAT1 phosphorylation in the presence of patient sera. A brief review of immunodeficiency caused by anti-IFNγ autoantibodies is also described.

Keywords: Anti-interferon gamma autoantibodies; Haemophagocytic lymphohistiocytosis; Tuberculosis.

Grants and funding

Z99 AI999999/ImNIH/Intramural NIH HHS/United States