To investigate the clinical characteristics and treatment of a patient with nontuberculous mycobacterium (Mycobacterium Columbia) disseminated infection caused by anti-interferon γ (IFN-γ) autoantibody syndrome.

A 66-year-old woman was hospitalized on November 21st, 2020 in Shenzhen Third People’s Hospital for "recurrent fever, with swollen and painful lymph nodes for 6 months" . The clinical course of this case with Mycobacterium Columbia disseminated infection caused by anti-IFN-γ syndrome was analyzed and relevant literatures were reviewed.

Mycobacterium Columbia infection was identified both by metagenomic next-generation sequencing (mNGS) from lymph node tissue and alveolar lavage fluid of this patient performed in other hospital. Positron emission tomography computer tomography (PET-CT) showed multiple lymph node enlargement, multiple bone destruction throughout the body and consolidated right upper lobe of the lung with significant metabolic activity of this patient. Physical examination showed diffused skin rash and multiple superficial enlarged lymph nodes with ulcer and a few pus. Peripheral blood of this patient: quantification of immunoglobulin G and immunoglobulin A, absolute count of T-lymphocyte, count of CD4⁺ T cell and CD8⁺ T cell were all normal. The blood specimen was detected with IFN-γ autoantibodies titer as 32 700 ng/ml (normal value < 5 000 ng/ml), and the diagnosis of Mycobacterium Columbia disseminated infection caused by anti-IFN-γ, autoantibody immunodeficiency syndrome was confirmed. Anti-Mycobacterium Columbia treatment and gamma globulin and hormone therapy were carried out. The patient’s rash subsided, the ruptured lymph node healed, the enlarged lymph node reduced significantly, and the condition improved. Anti-nontuberculous mycobacterium treatment was continued during the outpatient treatment and follow-up.

Clinically, for disseminated non-tuberculous mycobacterium-infected individuals, the possibility of anti-interferon antibody syndrome should be taken into account, and anti-IFN-γ detection should be performed to achieve the purpose of diagnosis, and immunotherapy should be performed besides treatment based on pathogen.