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Medical Microbiology and Immunology

, Volume 208, Issue 1, pp 33–37 | Cite as

Chylous ascites, anti-interferon-gamma autoantibody, and angioimmunoblastic T-cell lymphoma: a rare but intriguing connection over Mycobacterium avium

  • Yusuke KoizumiEmail author
  • Takuro Sakagami
  • Hitoshi Minamiguchi
  • Aya Makino
  • Ami Aoki
  • Keiko Hodohara
  • Hiroshige Mikamo
  • Akira Andoh
  • Yoshihide Fujiyama
Original Investigation

Abstract

We report a case of non-AIDS (acquired immunodeficiency syndrome), non-CAPD (Continuous Ambulatory Peritoneal Dialysis), non-cirrhotic, Mycobacterium avium peritonitis, which is a rare form of mycobacterial infection. A 66-year-old Japanese man who had been treated previously for angioimmunoblastic T-cell lymphoma (AITL), had developed disseminated M. avium infection. Antimycobacterial regimen improved his symptoms; however, following an interruption in treatment, he developed chylous ascites. The patient died of uncontrolled peritonitis despite intensive treatment. Anti-interferon-γ autoantibody was positive, and AITL was presumed to be involved in autoantibody production. A rare coexistence of chylous ascites, autoantibody, and AITL taught us an intriguing lesson on the pathogenesis of M. avium infection. Particularly, we conclude that treatment strategies for M. avium infection should aim to restore immunity.

Keywords

Disseminated Mycobacterium avium complex infection Angioimmunoblastic T-cell lymphoma Rituximab Anti-interferon-γ autoantibody Signal transducer and activator of transcription (STAT)1 

Notes

Acknowledgements

Yusuke Koizumi wrote this paper. Takuro Sakagami and Ami Aoki performed anti-IFN-γ autoantibody assay. Yusuke Koizumi, Hitoshi Minamiguchi, Aya Makino, and Keiko Hodohara made diagnosis, clinical decisions and treatment. Hiroshige Mikamo, Akira Andoh and Yoshihide Fujiyama contributed in giving advice from the point of Microbiology, Immunology and Hematology, respectively.

Funding

None of the authors has received any form of funding.

Compliance with ethical standards

Conflict of interest

None of the authors has financial relationships with any commercial entity with an interest in the subject of this manuscript.

Ethics approval

All the procedures have been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.

Informed consent

Informed consent was obtained from the patient after verbal and written information provision.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Clinical Infectious DiseasesAichi Medical University HospitalNagakuteJapan
  2. 2.Department of HematologyShiga University of Medical ScienceOtsuJapan
  3. 3.Department of Respiratory Medicine and Infectious DiseaseNiigata University Graduate School of Medical and Dental SciencesNiigataJapan

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