Disseminated Mycobacterium avium Infection Complicated with Chylous Ascites in a Patient with Neutralizing Autoantibodies to Interferon-γ

• Published in: Internal Medicine Vol. 59; no. 24; pp. 3195 - 3200
• Main Authors: Yamaba, Yusuke, Takakuwa, Osamu, Wang, Ziren, Saito, Manami, Kawae, Daisuke, Yoshihara, Misuzu, Kunii, Eiji, Ito, Yutaka, Akita, Kenji
• Format: Journal Article
• Language: English
• Published: Japan The Japanese Society of Internal Medicine 15.12.2020; Japan Science and Technology Agency
• Subjects: Aged; Anorexia; Ascites; Autoantibodies; Body weight loss; Case Report; chylous ascites; Chylous Ascites - etiology; disseminated nontuberculous mycobacteriosis; Fever; Humans; IFN-γAb; Interferon-gamma; Internal medicine; Male; Mycobacterium avium; Mycobacterium avium Complex; Mycobacterium avium-intracellulare Infection - complications; Mycobacterium avium-intracellulare Infection - drug therapy; Octreotide; Patients; γ-Interferon; chylous ascites; disseminated nontuberculous mycobacteriosis; IFN-γAb
• ISSN: 0918-2918; 1349-7235
• DOI: 10.2169/internalmedicine.3987-19

A 68-year-old man visited our hospital due to anorexia, weight loss and a fever. We diagnosed the patient with disseminated Mycobacterium avium complex (MAC) and confirmed the presence of interferon (IFN)-γ neutralizing autoantibodies (IFN-γAb). His lesions improved following antibiotic therapy, but chylous ascites (CA) developed seven months after treatment. CA was able to be controlled by subcutaneous octreotide and diet therapy. IFN-γAb is recognized as having a critical role in the pathogenesis of disseminated MAC disease, but its clinical features are not fully understood. CA may be a complication that develops during the treatment of disseminated MAC infection.