期刊
MYCOSES
卷 64, 期 6, 页码 576-582出版社
WILEY
DOI: 10.1111/myc.13247
关键词
autoantibodies; Cryptococcus; cytokines; fungus; immunodeficiency; meningitis
资金
- National Institutes of Health/National Cancer Institute [P30CA016672]
A previously healthy 26-year-old man developed disseminated cryptococcosis with high titres of anti-GM-CSF autoantibodies. This case highlights the importance for clinicians to be vigilant about anti-cytokine autoantibodies in patients without known immunodeficiencies who may develop disseminated infections by opportunistic intracellular pathogens.
The development of disseminated cryptococcosis has historically occurred in patients living with advanced human immunodeficiency virus or other immunosuppressive conditions affecting T-cell function. Recently, patients with anti-cytokine neutralising autoantibodies have been recognised to be at risk for disseminated infections by opportunistic intracellular pathogens, including Cryptococcus species. Herein, we present a previously healthy 26-year-old man who was evaluated with disseminated cryptococcosis involving the bone, lung, mediastinum and brain. The patient's serum cryptococcal antigen titres were >1:1,100,000, and evaluation for an underlying immunodeficiency revealed high titres for anti-granulocyte-macrophage colony-stimulating factor (GM-CSF) autoantibodies. We also review the literature of all published cases of disseminated cryptococcosis associated with the presence of anti-GM-CSF autoantibodies. Clinicians should have a heightened awareness of anti-cytokine autoantibodies in patients without a known immunodeficiency and development disseminated infections by opportunistic intracellular pathogens.
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