Adult Onset Immunodeficiency Associated with Anti-interferon Gamma Autoantibodies
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Published:
Feb 20, 2017
Keywords:
immunodeficiency, adult onset, anti-inteferon-gamma autoantibodies, NTM infection
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Abstract
Adult onset immunodeficiency associated with anti-interferon-gamma autoantibodiesis an emerging medical issue worldwide especially in South-east Asia. Most patientspresent with disseminated non-tuberculous mycobacteria (NTM) infection and otheropportunistic infections. In addition to standard antimicrobial therapy, immunomodulatoror immunosuppressive drug seem to play a role in some cases.
In the present study, we thoroughly reviewed the pathogenesis, clinical features,laboratory diagnosis, modalities of treatment, and clinical outcomes of this condition.
Article Details
How to Cite
1.
Laisuan W, Wongsa C, Intapiboon P, Dechapaphapeaktak N, Tongdee M, Oncham S, Kafaksom T, Rerkpattanapipat T. Adult Onset Immunodeficiency Associated with Anti-interferon Gamma Autoantibodies. BKK Med J [Internet]. 2017 Feb. 20 [cited 2024 Nov. 21];13(1):87. Available from: https://he02.tci-thaijo.org/index.php/bkkmedj/article/view/221806
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This is an open access article distributed under the terms of the Creative Commons Attribution Licence, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
References
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3. Mahaisavariya P, Chaiprasert A, Manonukul J, et al. Scrofuloderma and Sweet’s syndrome.Int J Dermatol 2002;41(1):28-31.
4. Sungkanuparph S, Sathapatayavongs B, Pracharktam R.Infections with rapidly growing mycobacteria: report of 20 cases.Int J Infect Dis 2003;7(3):198-205.
5. Chetchotisakd P, Kiertiburanakul S, Mootsikapun P, et al. Disseminated nontuberculous mycobacterial infection in patients who are not infected with HIV in Thailand. Clin Infect Dis 2007;45(4):421-7.
6. offnger R, Helbert MR, Barcenas-Morales G, et al.Autoantibodies to interferon-gamma in a patient with selective susceptibility to mycobacterial infection andorgan-specifc autoimmunity.Clin Infect Dis 2004;38(1):e10-4
7. Hoflich C, Sabat R, Rosseau S, et al. Naturally occurring anti-IFN-gamma autoantibody and severe infections with Mycobacterium cheloneae and Burkholderia cocovenenans. Blood 2004;103(2):673-5.
8. Patel SY, Ding L, Brown MR, et al. Anti-IFN-gamma autoantibodies in disseminated nontuberculous mycobacterial infections. J Immunol 2005;175(7):4769-76
9. Baerlecken N, Jacobs R, Stoll M, et al. Recurrent, multifocal Mycobacterium avium-intercellulare infection in a patient with interferon-gamma autoantibody. Clin Infect Dis 2009;49(7):e76-8.
10. Koya T, Tsubata C, Kagamu H, et al. Anti-interferongamma autoantibody in a patient with disseminated Mycobacterium avium complex.J Infect Chemother 2009;15(2):118-22.
11. Tang BS, Chan JF, Chen M, , et al. Disseminated penicilliosis, recurrent bacteremic nontyphoidal salmonellosis, and burkholderiosis associated with acquired immunodefciency due to autoantibody against gamma interferon. Clin Vaccine Immunol 2010;17(7):1132-8.
12. ampitak T, Suwanpimolkul G, Browne S, et al. Anti-interferon-gamma autoantibody and opportunistic infections: case series and review of the literature. Infection 2011;39(1):65-71.
13. rowne SK, Burbelo PD, Chetchotisakd P, et al. Adult-onset immunodefciency in Thailand and Taiwan.N Engl J Med 2012;367(8):725-34.
14. Chaisathaphol T, Jitmuang A. Disseminated Mycobacterium avium and recurrent Salmonella group D infection in a patient with autoantibodies to interferon-gamma. Southeast Asian J Trop Med Public Health 2013;44(3):460-7.
15. Ishii T, Tamura A, Matsui H, et al. Disseminated Mycobacterium avium complex infection in a patient carrying autoantibody to interferon-gamma.J Infect Chemother 2013;19(6):1152-7.
16. Nei T, Okabe M, Mikami I, et al. A non-HIV case with disseminated Mycobacterium kansasii disease associated with strong neutralizing autoantibody to interferon-gamma. Respir Med Rep 2013;8:10-3.
17. ongkulab P, Wipasa J, Chaiwarith R, et al. Autoantibody to interferon-gamma associated with adult-onset immunodefciency in non-HIV individuals in Northern Thailand. PloS one 2013;8(9):e76371.
18. DeLeon TT, Chung HH, Opal SM, et al. Mycobacterium avium complex empyema in a patient with interferon gamma autoantibodies.Hawai’i J Med Public Health 2014;73(9 Suppl 1):15-7.
19. O’Connell E, Rosen LB, LaRue RW, et al. The first US domestic report of disseminated Mycobacterium avium complex and anti-interferon-gamma autoantibodies.J Clin Immunol 2014;34(8):928-32.
20. Suzuki K, Terada J, Sasaki Y, Kawasaki T, et al. Pulmonary Mycobacterium fortuitum infection with cervical lymphadenitis in a patient carrying autoantibodies to interferon-gamma.Intern Med 2014;53(12):1361-4.
21. Hanitsch LG, Lobel M, Muller-Redetzky H, et al.
Late-Onset Disseminated Mycobacterium avium intracellulare Complex Infection (MAC), Cerebral Toxoplasmosis and Salmonella Sepsis in a German Caucasian Patient with Unusual Anti-Interferon-Gamma IgG1 Autoantibodies. J Clin Immunol 2015;35(4):361-5.
22. Hase I, Morimoto K, Sakagami T, et al. Disseminated Mycobacterium gordonae and Mycobacterium mantenii infection with elevated anti-IFN-gamma neutralizing autoantibodies.J Infect Chemother 2015;21(6):468-72.
23. Nishimura T, Fujita-Suzuki Y, Yonemaru M, et al.
Recurrence of disseminated Mycobacterium avium complex disease in a patient with anti-gamma interferon autoantibodies by reinfection.J Clinical Microbiol 2015;53(4):1436-8.
24. Poulin S, Corbeil C, Nguyen M, et al. Fatal Mycobacterium colombiense/cytomegalovirus coinfection associated with acquired immunodefciency due to autoantibodies against interferon gamma: a case report. BMC Infect Dis 2013;13:24.
25. Chan JF, Yee KS, Tang BS, et al. Adult-onset immunodefciency due to anti-interferon-gamma autoantibody in mainland Chinese.Chin Med J (Eng) 2014;127(6):1189-90.
26. Valour F, Perpoint T, Senechal A, et al. Interferon-gamma Autoantibodies as Predisposing Factor for Nontuberculous Mycobacterial Infection.Emerg Infect Dis 2016;22(6): 1124-6.
27. Haverkamp MH, van Dissel JT, Holland SM. Human host genetic factors in nontuberculous mycobacterial infection: lessons from single gene disorders affecting innate and adaptive immunity and lessons from molecular defects in interferon-gamma-dependent signaling.Microbes Infect 2006;8(4):1157-66.
28. Gutierrez MG, Master SS, Singh SB, et al. Autophagy is a defense mechanism inhibiting BCG and Mycobacterium tuberculosis survival in infected macrophages.Cell 2004;119(6):753-66
29. Wu UI, Holland SM. Host susceptibility to non-tuberculous mycobacterial infections. Lancet Infect Dis 2015;15(8):968-80.
30. van de Vosse E, Hoeve MA, Ottenhoff TH. Human genetics of intracellular infectious diseases: molecular and cellular immunity against mycobacteria and salmonellae. Lancet Infect Dis 2004;4(12):739-49.
31. Holland SM. Interferon gamma, IL-12, IL-12R and STAT-1 immunodefciency diseases: disorders of the interface of innate and adaptive immunity.Immunol Res 2007;38 (1-3):342-6.
32. Zerbe CS, Holland SM. Disseminated histoplasmosis in persons with interferon-gamma receptor 1 defciency. Clin Infect Dis2005;41(4):e38-41.
33. Vinh DC, Masannat F, Dzioba RB, et al. Refractory disseminated coccidioidomycosis and mycobacteriosis in interferon-gamma receptor 1 defciency.Clin Infect Dis 2009;49(6):e62-5.
34. Sampaio EP, Hsu AP, Pechacek J, et al. Signal transducer and activator of transcription 1 (STAT1) gain-of-function mutations and disseminated coccidioidomycosis and histoplasmosis.J Allergy Clin Immunol 2013;131(6): 1624-34.
35. Picard C, Fieschi C, Altare F, et al. Inherited interleukin-12 deficiency: IL12B genotype and clinical phenotype of 13 patients from six kindreds.Am J Hum Genet 2002;70(2): 336-48.
36. Prando C, Samarina A, Bustamante J, et al. Inherited IL-12p40 defciency: genetic, immunologic, and clinical features of 49 patients from 30 kindreds.Medicine 2013;92(2):109-22.
37. Fieschi C, Dupuis S, Catherinot E, et al. Low penetrance, broad resistance, and favorable outcome of interleukin 12 receptor beta1 defciency: medical and immunological implications.J Exp Med 2003;197(4):527-35.
38. Gruenberg DA, Anover-Sombke S, Gern JE, et al. Atypical presentation of IL-12 receptor beta1 defciency with pneumococcal sepsis and disseminated nontuberculous mycobacterial infection in a 19-month-old girl born to nonconsanguineous US residents.J Allergy Clin Immunol 2010;125(1):264-5.
39. Bogunovic D, Byun M, Durfee LA, et al. Mycobacterial disease and impaired IFN-gamma immunity in humans with inherited ISG15 deficiency.Science 2012;337(6102):1684-8.
40. Kilic SS, van Wengen A, de Paus RA, et al. Severe disseminated mycobacterial infection in a boy with a novel mutation leading to IFN-gammaR2 defciency.J Infect 2012;65(6):568-72.
41. Kong XF, Vogt G, Itan Y, et al. Haploinsuffciency at the human IFNGR2 locus contributes to mycobacterial disease. Hum Mol Genet 2013;22(4):769-81.
42. Kristensen IA, Veirum JE, Moller BK, et al. Novel STAT1 alleles in a patient with impaired resistance to mycobacteria. J Clin Immunol 2011;31(2):265-71.
43. Vairo D, Tassone L, Tabellini G, et al. Severe impairment of IFN-gamma and IFN-alpha responses in cells of a patient with a novel STAT1 splicing mutation.Blood 2011;118(7):1806-17.
44. Hambleton S, Salem S, Bustamante J, et al. IRF8 mutations and human dendritic-cell immunodefciency.N Engl J Med 2011;365(2):127-38.
45. Niehues T, Reichenbach J, Neubert J, et al. Nuclear factor kappaB essential modulator-defcient child with immunodefciency yet without anhidrotic ectodermal dysplasia.J Allergy Clin Immunol 2004;114(6):1456-62.
46. Niehues T, Reichenbach J, Neubert J, et al. Nuclear factor kappaB essential modulator-defcient child with immunodefciency yet without anhidrotic ectodermal dysplasia.J Allergy Clin Immunol 2004;114(6):1456-62.
47. Bustamante J, Arias AA, Vogt G, et al. Germline CYBB mutations that selectively affect macrophages in kindreds with X-linked predisposition to tuberculous mycobacterial disease.Nat Immunol 2011;12(3):213-21.
48. Filipe-Santos O, Bustamante J, Chapgier A, et al. Inborn errors of IL-12/23- and IFN-gamma-mediated immunity: molecular, cellular, and clinical features.Semin Immunol 2006;18(6):347-61.
49. Ling KW, Ottersbach K, van Hamburg JP, et al. GATA-2 plays two functionally distinct roles during the ontogeny of hematopoietic stem cells.J Exp Med 2004;200(7): 871-82.
50. Vinh DC, Patel SY, Uzel G, et al. Autosomal dominant and sporadic monocytopenia with susceptibility to mycobacteria, fungi, papillomaviruses, and myelodysplasia.Blood 2010;115(8):1519-29.
51. Spinner MA, Sanchez LA, Hsu AP, et al. GATA2 deficiency: a protean disorder of hematopoiesis, lymphatics, and immunity.Blood 2014;123(6):809-21.
52. Chi CY, Chu CC, Liu JP, et al. Anti-IFN-gamma autoantibodies in adults with disseminated nontuberculous mycobacterial infections are associated with HLADRB1*16:02 and HLA-DQB1*05:02 and the reactivationof latent varicella-zoster virus infection.Blood 2013;121(8):1357-66.
53. Pithukpakorn M, Roothumnong E, Angkasekwinai N, et al. HLA-DRB1 and HLA-DQB1 Are Associated with Adult-Onset Immunodefciency with Acquired AntiInterferon-Gamma Autoantibodies.PloS one 2015;10(5):e0128481
54. Picard C, Al-Herz W, Bousfha A, et al. Primary Immunodefciency Diseases: an Update on the Classifcation from the International Union of Immunological Societies Expert Committee for Primary Immunodefciency 2015.J Clin Immunol2015;35(8):696-726.
55. Chi CY, Lin CH, Ho MW, et al. Clinical manifestations, course, and outcome of patients with neutralizing anti-interferon-gamma autoantibodies and disseminated nontuberculous mycobacterial infections.Medicine 2016;95(25):e3927.
56. Reitz C, Brayne C, Mayeux R. Epidemiology of Alzheimer disease. Nat Rev Neurol 2011;7:137-152
57. Lam DW, LeRoith D. The worldwide diabetes epidemic. Curr Opin Endocrinol Diabetes Obes 2012;19:93-96
58. Gorelick PB, Scuteri A, Black SE, et al. Vascular contributions to cognitive impairment and dementia: a statement for healthcare professionals from the American Heart Association/American Stroke Association. Stroke 2011;42:2672-2713
2. hetchotisakd P, Mootsikapun P, Anunnatsiri S, et al.Disseminated infection due to rapidly growing mycobacteria in immunocompetent hosts presentingwith chronic lymphadenopathy: a previously unrecognized clinical entity.Clin Infect Dis 2000;30(1):29-34.
3. Mahaisavariya P, Chaiprasert A, Manonukul J, et al. Scrofuloderma and Sweet’s syndrome.Int J Dermatol 2002;41(1):28-31.
4. Sungkanuparph S, Sathapatayavongs B, Pracharktam R.Infections with rapidly growing mycobacteria: report of 20 cases.Int J Infect Dis 2003;7(3):198-205.
5. Chetchotisakd P, Kiertiburanakul S, Mootsikapun P, et al. Disseminated nontuberculous mycobacterial infection in patients who are not infected with HIV in Thailand. Clin Infect Dis 2007;45(4):421-7.
6. offnger R, Helbert MR, Barcenas-Morales G, et al.Autoantibodies to interferon-gamma in a patient with selective susceptibility to mycobacterial infection andorgan-specifc autoimmunity.Clin Infect Dis 2004;38(1):e10-4
7. Hoflich C, Sabat R, Rosseau S, et al. Naturally occurring anti-IFN-gamma autoantibody and severe infections with Mycobacterium cheloneae and Burkholderia cocovenenans. Blood 2004;103(2):673-5.
8. Patel SY, Ding L, Brown MR, et al. Anti-IFN-gamma autoantibodies in disseminated nontuberculous mycobacterial infections. J Immunol 2005;175(7):4769-76
9. Baerlecken N, Jacobs R, Stoll M, et al. Recurrent, multifocal Mycobacterium avium-intercellulare infection in a patient with interferon-gamma autoantibody. Clin Infect Dis 2009;49(7):e76-8.
10. Koya T, Tsubata C, Kagamu H, et al. Anti-interferongamma autoantibody in a patient with disseminated Mycobacterium avium complex.J Infect Chemother 2009;15(2):118-22.
11. Tang BS, Chan JF, Chen M, , et al. Disseminated penicilliosis, recurrent bacteremic nontyphoidal salmonellosis, and burkholderiosis associated with acquired immunodefciency due to autoantibody against gamma interferon. Clin Vaccine Immunol 2010;17(7):1132-8.
12. ampitak T, Suwanpimolkul G, Browne S, et al. Anti-interferon-gamma autoantibody and opportunistic infections: case series and review of the literature. Infection 2011;39(1):65-71.
13. rowne SK, Burbelo PD, Chetchotisakd P, et al. Adult-onset immunodefciency in Thailand and Taiwan.N Engl J Med 2012;367(8):725-34.
14. Chaisathaphol T, Jitmuang A. Disseminated Mycobacterium avium and recurrent Salmonella group D infection in a patient with autoantibodies to interferon-gamma. Southeast Asian J Trop Med Public Health 2013;44(3):460-7.
15. Ishii T, Tamura A, Matsui H, et al. Disseminated Mycobacterium avium complex infection in a patient carrying autoantibody to interferon-gamma.J Infect Chemother 2013;19(6):1152-7.
16. Nei T, Okabe M, Mikami I, et al. A non-HIV case with disseminated Mycobacterium kansasii disease associated with strong neutralizing autoantibody to interferon-gamma. Respir Med Rep 2013;8:10-3.
17. ongkulab P, Wipasa J, Chaiwarith R, et al. Autoantibody to interferon-gamma associated with adult-onset immunodefciency in non-HIV individuals in Northern Thailand. PloS one 2013;8(9):e76371.
18. DeLeon TT, Chung HH, Opal SM, et al. Mycobacterium avium complex empyema in a patient with interferon gamma autoantibodies.Hawai’i J Med Public Health 2014;73(9 Suppl 1):15-7.
19. O’Connell E, Rosen LB, LaRue RW, et al. The first US domestic report of disseminated Mycobacterium avium complex and anti-interferon-gamma autoantibodies.J Clin Immunol 2014;34(8):928-32.
20. Suzuki K, Terada J, Sasaki Y, Kawasaki T, et al. Pulmonary Mycobacterium fortuitum infection with cervical lymphadenitis in a patient carrying autoantibodies to interferon-gamma.Intern Med 2014;53(12):1361-4.
21. Hanitsch LG, Lobel M, Muller-Redetzky H, et al.
Late-Onset Disseminated Mycobacterium avium intracellulare Complex Infection (MAC), Cerebral Toxoplasmosis and Salmonella Sepsis in a German Caucasian Patient with Unusual Anti-Interferon-Gamma IgG1 Autoantibodies. J Clin Immunol 2015;35(4):361-5.
22. Hase I, Morimoto K, Sakagami T, et al. Disseminated Mycobacterium gordonae and Mycobacterium mantenii infection with elevated anti-IFN-gamma neutralizing autoantibodies.J Infect Chemother 2015;21(6):468-72.
23. Nishimura T, Fujita-Suzuki Y, Yonemaru M, et al.
Recurrence of disseminated Mycobacterium avium complex disease in a patient with anti-gamma interferon autoantibodies by reinfection.J Clinical Microbiol 2015;53(4):1436-8.
24. Poulin S, Corbeil C, Nguyen M, et al. Fatal Mycobacterium colombiense/cytomegalovirus coinfection associated with acquired immunodefciency due to autoantibodies against interferon gamma: a case report. BMC Infect Dis 2013;13:24.
25. Chan JF, Yee KS, Tang BS, et al. Adult-onset immunodefciency due to anti-interferon-gamma autoantibody in mainland Chinese.Chin Med J (Eng) 2014;127(6):1189-90.
26. Valour F, Perpoint T, Senechal A, et al. Interferon-gamma Autoantibodies as Predisposing Factor for Nontuberculous Mycobacterial Infection.Emerg Infect Dis 2016;22(6): 1124-6.
27. Haverkamp MH, van Dissel JT, Holland SM. Human host genetic factors in nontuberculous mycobacterial infection: lessons from single gene disorders affecting innate and adaptive immunity and lessons from molecular defects in interferon-gamma-dependent signaling.Microbes Infect 2006;8(4):1157-66.
28. Gutierrez MG, Master SS, Singh SB, et al. Autophagy is a defense mechanism inhibiting BCG and Mycobacterium tuberculosis survival in infected macrophages.Cell 2004;119(6):753-66
29. Wu UI, Holland SM. Host susceptibility to non-tuberculous mycobacterial infections. Lancet Infect Dis 2015;15(8):968-80.
30. van de Vosse E, Hoeve MA, Ottenhoff TH. Human genetics of intracellular infectious diseases: molecular and cellular immunity against mycobacteria and salmonellae. Lancet Infect Dis 2004;4(12):739-49.
31. Holland SM. Interferon gamma, IL-12, IL-12R and STAT-1 immunodefciency diseases: disorders of the interface of innate and adaptive immunity.Immunol Res 2007;38 (1-3):342-6.
32. Zerbe CS, Holland SM. Disseminated histoplasmosis in persons with interferon-gamma receptor 1 defciency. Clin Infect Dis2005;41(4):e38-41.
33. Vinh DC, Masannat F, Dzioba RB, et al. Refractory disseminated coccidioidomycosis and mycobacteriosis in interferon-gamma receptor 1 defciency.Clin Infect Dis 2009;49(6):e62-5.
34. Sampaio EP, Hsu AP, Pechacek J, et al. Signal transducer and activator of transcription 1 (STAT1) gain-of-function mutations and disseminated coccidioidomycosis and histoplasmosis.J Allergy Clin Immunol 2013;131(6): 1624-34.
35. Picard C, Fieschi C, Altare F, et al. Inherited interleukin-12 deficiency: IL12B genotype and clinical phenotype of 13 patients from six kindreds.Am J Hum Genet 2002;70(2): 336-48.
36. Prando C, Samarina A, Bustamante J, et al. Inherited IL-12p40 defciency: genetic, immunologic, and clinical features of 49 patients from 30 kindreds.Medicine 2013;92(2):109-22.
37. Fieschi C, Dupuis S, Catherinot E, et al. Low penetrance, broad resistance, and favorable outcome of interleukin 12 receptor beta1 defciency: medical and immunological implications.J Exp Med 2003;197(4):527-35.
38. Gruenberg DA, Anover-Sombke S, Gern JE, et al. Atypical presentation of IL-12 receptor beta1 defciency with pneumococcal sepsis and disseminated nontuberculous mycobacterial infection in a 19-month-old girl born to nonconsanguineous US residents.J Allergy Clin Immunol 2010;125(1):264-5.
39. Bogunovic D, Byun M, Durfee LA, et al. Mycobacterial disease and impaired IFN-gamma immunity in humans with inherited ISG15 deficiency.Science 2012;337(6102):1684-8.
40. Kilic SS, van Wengen A, de Paus RA, et al. Severe disseminated mycobacterial infection in a boy with a novel mutation leading to IFN-gammaR2 defciency.J Infect 2012;65(6):568-72.
41. Kong XF, Vogt G, Itan Y, et al. Haploinsuffciency at the human IFNGR2 locus contributes to mycobacterial disease. Hum Mol Genet 2013;22(4):769-81.
42. Kristensen IA, Veirum JE, Moller BK, et al. Novel STAT1 alleles in a patient with impaired resistance to mycobacteria. J Clin Immunol 2011;31(2):265-71.
43. Vairo D, Tassone L, Tabellini G, et al. Severe impairment of IFN-gamma and IFN-alpha responses in cells of a patient with a novel STAT1 splicing mutation.Blood 2011;118(7):1806-17.
44. Hambleton S, Salem S, Bustamante J, et al. IRF8 mutations and human dendritic-cell immunodefciency.N Engl J Med 2011;365(2):127-38.
45. Niehues T, Reichenbach J, Neubert J, et al. Nuclear factor kappaB essential modulator-defcient child with immunodefciency yet without anhidrotic ectodermal dysplasia.J Allergy Clin Immunol 2004;114(6):1456-62.
46. Niehues T, Reichenbach J, Neubert J, et al. Nuclear factor kappaB essential modulator-defcient child with immunodefciency yet without anhidrotic ectodermal dysplasia.J Allergy Clin Immunol 2004;114(6):1456-62.
47. Bustamante J, Arias AA, Vogt G, et al. Germline CYBB mutations that selectively affect macrophages in kindreds with X-linked predisposition to tuberculous mycobacterial disease.Nat Immunol 2011;12(3):213-21.
48. Filipe-Santos O, Bustamante J, Chapgier A, et al. Inborn errors of IL-12/23- and IFN-gamma-mediated immunity: molecular, cellular, and clinical features.Semin Immunol 2006;18(6):347-61.
49. Ling KW, Ottersbach K, van Hamburg JP, et al. GATA-2 plays two functionally distinct roles during the ontogeny of hematopoietic stem cells.J Exp Med 2004;200(7): 871-82.
50. Vinh DC, Patel SY, Uzel G, et al. Autosomal dominant and sporadic monocytopenia with susceptibility to mycobacteria, fungi, papillomaviruses, and myelodysplasia.Blood 2010;115(8):1519-29.
51. Spinner MA, Sanchez LA, Hsu AP, et al. GATA2 deficiency: a protean disorder of hematopoiesis, lymphatics, and immunity.Blood 2014;123(6):809-21.
52. Chi CY, Chu CC, Liu JP, et al. Anti-IFN-gamma autoantibodies in adults with disseminated nontuberculous mycobacterial infections are associated with HLADRB1*16:02 and HLA-DQB1*05:02 and the reactivationof latent varicella-zoster virus infection.Blood 2013;121(8):1357-66.
53. Pithukpakorn M, Roothumnong E, Angkasekwinai N, et al. HLA-DRB1 and HLA-DQB1 Are Associated with Adult-Onset Immunodefciency with Acquired AntiInterferon-Gamma Autoantibodies.PloS one 2015;10(5):e0128481
54. Picard C, Al-Herz W, Bousfha A, et al. Primary Immunodefciency Diseases: an Update on the Classifcation from the International Union of Immunological Societies Expert Committee for Primary Immunodefciency 2015.J Clin Immunol2015;35(8):696-726.
55. Chi CY, Lin CH, Ho MW, et al. Clinical manifestations, course, and outcome of patients with neutralizing anti-interferon-gamma autoantibodies and disseminated nontuberculous mycobacterial infections.Medicine 2016;95(25):e3927.
56. Reitz C, Brayne C, Mayeux R. Epidemiology of Alzheimer disease. Nat Rev Neurol 2011;7:137-152
57. Lam DW, LeRoith D. The worldwide diabetes epidemic. Curr Opin Endocrinol Diabetes Obes 2012;19:93-96
58. Gorelick PB, Scuteri A, Black SE, et al. Vascular contributions to cognitive impairment and dementia: a statement for healthcare professionals from the American Heart Association/American Stroke Association. Stroke 2011;42:2672-2713