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.
Disseminated Mycobacterium avium complex infection Angioimmunoblastic T-cell lymphoma Rituximab Anti-interferon-γ autoantibody Signal transducer and activator of transcription (STAT)1
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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.
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.
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 was obtained from the patient after verbal and written information provision.
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