Disseminated Mycobacterium avium complex infection in a child with partial dominant interferon gamma receptor 1 deficiency in India

J Clin Immunol. 2015 Jul;35(5):459-62. doi: 10.1007/s10875-015-0173-1. Epub 2015 Jun 9.

Abstract

Mendelian susceptibility to mycobacterial disease (MSMD) is a rare condition characterized by clinical disease caused by weakly virulent mycobacteria. All genes mutated in MSMD patients are involved in IFN-γ immunity. Autosomal partial dominant (PD) interferon-γ receptor 1 (IFN-γR1) deficiency is the most frequent abnormality affecting the group of MSMD patients leading to impaired response of IFN-γ. We describe here a patient from India with disseminated infection due to Mycobacterium avium intracellulare (MAC) including multifocal osteomyelitis and BCG disease. A heterozygous mutation in exon 6 of IFNGR1 gene was identified, conferring an autosomal PD IFN-γR1 deficiency. Patient had recurrence of mycobacterial disease during antibiotic therapy for which subcutaneous IFN-γ was added as a modality of treatment for resistant MAC infection.

Publication types

  • Case Reports
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anti-Bacterial Agents / therapeutic use
  • Child
  • Drug Therapy, Combination
  • Genes, Dominant / genetics
  • Humans
  • India
  • Interferon gamma Receptor
  • Interferon-gamma / therapeutic use
  • Male
  • Mutation / genetics
  • Mycobacterium avium Complex / immunology*
  • Mycobacterium avium-intracellulare Infection / diagnosis*
  • Mycobacterium avium-intracellulare Infection / genetics
  • Mycobacterium avium-intracellulare Infection / therapy
  • Osteomyelitis / genetics
  • Osteomyelitis / immunology*
  • Osteomyelitis / therapy
  • Receptors, Interferon / genetics*

Substances

  • Anti-Bacterial Agents
  • Receptors, Interferon
  • Interferon-gamma

Supplementary concepts

  • Chronic recurrent multifocal osteomyelitis