Abstract:

Objective: To report the diagnosis and treatment of a case of multi-drug resistant tuberculosis complicated with multiple infections such as marneffei caused by positive anti interferon gamma auto-antibody, and analyzes the clinical characteristics, laboratory examination, treatment and prognosis of the disease combined with literature. Methods: The study retrospectively analyzed the clinical data of a case of multi-drug resistant tuberculosis complicated with multiple infections such as marneffei caused by positive anti interferon gamma auto-antibodies admitted to Beijing Chest Hospital affiliated to Capital Medical University on August 2, 2023. The search deadline is May 31, 2024. The relevant literature was not retrieved from PubMed database with “Anti interferon-γ auto-antibodies, Multi-drug resistant tuberculosis” as the search term, Wanfang database and CNKI database with “Anti-interferon-γ auto-antibodies, multi drug resistant tuberculosis” as the search term. However, “anti interferon gamma auto-antibodies and anti interferon gamma auto-antibodies” were detected in Wanfang database, CNKI and PubMed database respectively, and two anti interferon gamma auto-antibodies were detected with drug sensitive tuberculosis, 61 anti interferon gamma auto-antibodies were detected with opportunistic infection, and 17 anti-interferon-γ auto-antibodies were detected with related treatment. Summarize the patient’s characteristics and conduct relevant literature review. Results: After immune evaluation, the patient was found to have abnormal cellular immunity and gene mutations. Due to adverse drug reactions and poor general physical condition, the best treatment opportunity was missed and the desired effect was not achieved. According to literature research, 65 cases were complicated with two or more opportunistic infections, 50 cases had skin damage, and there was no previous literature report on anti-interferon-γ auto-antibodies complicated with multi-drug resistant tuberculosis. In the acquired immunodeficiency syndrome patients with positive anti-interferon-γ auto-antibodies reported in the literature, 71 cases of Marneffei’s basket shaped mycosis, 31 cases of non-tuberculous mycobacterial disease, and 2 cases of tuberculosis were opportunistic infection pathogens. Among them, 65 patients developed two or more opportunistic infections, and 50 patients had skin damage. Conclusion: Patients with positive anti-interferon-γ auto-antibodies may have multiple infections and poor treatment outcomes. Early use of new immune preparations combined with targeted treatment for related pathogens may achieve better prognosis.

Key words: Anti-interferon-γ auto-antibodies, Tuberculosis, multi-drug resistant, Immunotherapy