Clinical features of nontuberculous mycobacteria disease patients with positive anti-interferon γ autoantibody
Objective To investigate the clinical features of nontuberculous mycobacteria(NTM)disease patients with positive anti-interferon γ(IFN-γ)autoantibody.Methods Forty-three adult human immunodeficiency virus-uninfected patients with NTM disease hospitalized in Huashan Hospital,Fudan University and Jing'an Branch,Huashan Hospital,Fudan University from July 2021 to August 2023 were included.Clinical data and NTM strain information of the patients were collected.The plasma levels of anti-IFN-γ autoantibodies were detected by enzyme-linked immunosorbent assay,and the patients were divided into antibody positive group and antibody negative group.The clinical characteristics and laboratory examination results between the two groups were compared.The independent sample t test,Mann-Whitney U test and chi-square test were used for statistical analysis.Multivariate logistic regression analysis was used to determine the correlation factors of positive anti-IFN-γ autoantibodies.Results Among the 43 patients,13 cases(30.2％)were positive for anti-IFN-γ autoantibodies and 30 cases(69.8％)were negative.The proportions of patients with NTM disseminated infection(9/13 vs 30.0％(9/30))and combined bacterial infection(5/13 vs 6.7％(2/30))in antibody positive group were both higher than those in antibody negative group,and the differences were both statistically significant(x2=5.74 and 6.73,respectively,both P＜0.05).The white blood cell count,platelet count,the proportion of platelet count＞350 × 109/L of antibody positive patients were all higher than those of antibody negative group,while the white sphere ratio was lower than that of antibody negative group,with statistical significance(t=2.42,3.02,x2=9.77 and t=3.66,respectively,all P＜0.05).Erythrocyte sedimentation rate,C-reactive protein,procalcitonin,globulin,immunoglobulin G,immunoglobulin A and immunoglobulin M in antibody positive patients were all higher than those in antibody negative group,and the differences were all statistically significant(U=99.50,112.00,115.50,61.50,76.50,99.00 and 83.00,respectively,all P＜0.05).Mycobacterium abscessus complex(seven cases and 11 cases,respectively)and Mycobacterium avium complex(five cases and 13 cases,respectively)were the main isolated strains in antibody positive and antibody negative patients.Multivariate logistic regression analysis showed that combined with bacterial infection(odds ratio(OR)=21.83,95％confidence interval(CI)1.94 to 245.71),NTM disseminated infection(OR=7.64,95％CI 1.10 to 53.26),platelet count＞350 × 109/L(OR=14.31,95％CI 1.91 to107.04)were risk factors for anti-IFN-γ autoantibodies positive(all P＜0.05).Conclusions Patients with positive anti-IFN-γ autoantibodies have higher probability of having elevated levels of systemic inflammation.Anti-IFN-γ autoantibody test is recommended for patients with NTM disease who present with co-bacterial infection,NTM disseminated infection,or elevated platelet count(＞350 × 109/L).
Nontuberculous mycobacteriaAnti-interferon-γ autoantibodyClinical features
NETL
NSTL
万方数据
