Abstract | BACKGROUND: Studies conducted in vitro and in animals suggest that cytokine signals to monocytes or macrophages by interferon gamma are important in the containment and clearance of disseminated nontuberculous mycobacterial infections. METHODS: We studied seven patients with refractory, disseminated nontuberculous mycobacterial infections who were not infected with the human immunodeficiency virus. Three patients were from a family predisposed to the development of Mycobacterium avium complex infections; four patients had idiopathic CD4+ T-lymphocytopenia. Their infections were culture- or biopsy-proved, involved at least two organ systems, and had been treated with the maximal tolerated medical therapy. Cellular proliferation, cytokine production, and phagocyte function were assessed in peripheral-blood cells. Interferon gamma was administered subcutaneously two or three times weekly in a dose of 25 to 50 micrograms per square meter of body-surface area in addition to antimycobacterial medications. Clinical effects were monitored by cultures, biopsies, radiographs, and in one patient a change in the need for paracentesis. RESULTS: CONCLUSIONS:
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Authors | S M Holland, E M Eisenstein, D B Kuhns, M L Turner, T A Fleisher, W Strober, J I Gallin |
Journal | The New England journal of medicine
(N Engl J Med)
Vol. 330
Issue 19
Pg. 1348-55
(May 12 1994)
ISSN: 0028-4793 [Print] United States |
PMID | 7908719
(Publication Type: Case Reports, Journal Article)
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Chemical References |
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Topics |
- Adult
- Bacteremia
(therapy)
- CD4-Positive T-Lymphocytes
- Child, Preschool
- Family Health
- Humans
- Interferon-gamma
(adverse effects, therapeutic use)
- Leukocyte Count
- Male
- Middle Aged
- Mycobacterium Infections, Nontuberculous
(immunology, therapy)
- Mycobacterium avium-intracellulare Infection
(immunology, therapy)
- Osteomyelitis
(therapy)
- Skin Diseases, Bacterial
(therapy)
- Tuberculosis, Pulmonary
(therapy)
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