Endobronchial Lesions from Disseminated Mycobacterium avium Infection in a Patient with Anti-interferon-gamma Autoantibodies

Intern Med. 2021 Oct 15;60(20):3267-3272. doi: 10.2169/internalmedicine.6693-20. Epub 2021 Apr 26.

Abstract

A 78-year-old man was admitted to our hospital with a fever and left chest pain. Computed tomography showed multiple lung nodules, narrowing of the right bronchus intermedius with mediastinal lymphadenopathy, and an osteolytic lesion. Bronchoscopic findings showed rapid progression of multiple polypoid lesions and the bronchial stenosis. A biopsy of the endobronchial lesions revealed non-necrotizing granulomatous inflammation, and a tissue culture identified Mycobacterium avium. An anti-human immunodeficiency virus antibody was negative. Finally, anti-interferon-gamma (IFN-γ) autoantibodies were detected, and the patient was diagnosed with disseminated nontuberculous mycobacterium infection with anti-IFN-γ autoantibodies. Antimycobacterial therapy was effective, and radiographic findings, including the endobronchial lesions, were resolved.

Keywords: Mycobacterium avium; anti-interferon-gamma autoantibodies; disseminated nontuberculous mycobacterium infection; endobronchial lesion.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Autoantibodies*
  • Humans
  • Interferon-gamma
  • Male
  • Mycobacterium avium
  • Mycobacterium avium Complex
  • Mycobacterium avium-intracellulare Infection* / diagnosis
  • Mycobacterium avium-intracellulare Infection* / drug therapy

Substances

  • Autoantibodies
  • Interferon-gamma