Abstract | BACKGROUND: Non-Tuberculous Mycobacterial- pulmonary disease (NTM-PD) is increasing in incidence and prevalence. Mycobacterium abscessus (M.abscessus) is a rapid growing multi-resistant NTM associated with severe NTM-PD requiring prolonged antibiotic therapy. Complications of therapy are common but reports on direct complications of active NTM-PD are rare. Vasculitis has been described as a rare complication of NTM-PD, most often in individuals with inherited immune defects. This case is the first to describe an ANCA positive vasculitide ( Microscopic Polyangiitis) secondary to M.abscessus pulmonary disease. CASE PRESENTATION: CONCLUSIONS: This is the first reported case of an ANCA positive vasculitis secondary to M.abscessus pulmonary disease. This rare but important complication had a significant impact on the patient adding to the complexity of an already significant disease and treatment burden. The potential role of reduced interferon-gamma production in this case highlights the importance of investigating immune function in those with mycobacterial infection and the intricate relationship between mycobacterial infection and immune dysfunction. Immune dysfunction caused by genetic defects or immunosuppressive therapy is a known risk factor for NTM-PD. Balancing immunosuppressive therapy with prolonged antimicrobial treatment is challenging and likely to become more common as the number of individuals being treated with biologics and immunosuppressive agents increases.
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Authors | C Addy, G Doran, A L Jones, G Wright, S Caskey, D G Downey |
Journal | BMC pulmonary medicine
(BMC Pulm Med)
Vol. 18
Issue 1
Pg. 170
(Nov 19 2018)
ISSN: 1471-2466 [Electronic] England |
PMID | 30453935
(Publication Type: Case Reports, Journal Article)
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Chemical References |
- Anti-Bacterial Agents
- Antibodies, Antineutrophil Cytoplasmic
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Topics |
- Aged
- Anti-Bacterial Agents
(therapeutic use)
- Antibodies, Antineutrophil Cytoplasmic
(blood)
- Bronchiectasis
(complications)
- Female
- Humans
- Microscopic Polyangiitis
(diagnosis)
- Mycobacterium Infections, Nontuberculous
(complications, drug therapy)
- Mycobacterium abscessus
(isolation & purification)
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