1. Treatment of disseminated mycobacterial infection with high-dose IFN-γ in a patient with IL-12Rβ1 deficiency.
- Author
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Alangari AA, Al-Zamil F, Al-Mazrou A, Al-Muhsen S, Boisson-Dupuis S, Awadallah S, Kambal A, and Casanova JL
- Subjects
- Child, Preschool, Female, Humans, Interferon-gamma administration & dosage, Interferon-gamma adverse effects, Lymphocyte Activation, Mycobacterium Infections immunology, Mycobacterium Infections microbiology, Mycobacterium bovis immunology, Receptors, Interleukin-12 genetics, Treatment Outcome, BCG Vaccine adverse effects, Interferon-gamma therapeutic use, Mycobacterium Infections drug therapy, Mycobacterium bovis drug effects, Receptors, Interleukin-12 deficiency
- Abstract
IFN-γ has been used in the treatment of IL-12Rβ1 deficiency patients with disseminated BCG infection (BCGosis), but the optimal dose to reach efficacy is not clear. We used IFN-γ in the treatment of a 2.7-year-old patient with IL-12Rβ1 deficiency and refractory BCG-osis. IFNγ was started at a dose of 50 μg/m² 3 times per week. The dose was upgraded to 100 mcg/m² after 3 months, then to 200 mcg/m² 6 months afterwards. Serum mycobactericidal activity and lymphocytes number and function were evaluated throughout the study. There was no clinical response to IFN-γ with 50 or 100 μg/m² doses. However, there was some response to the 200 μg/m² dose with no additional adverse effects. The serum mycobactericidal activity was not significantly different during the whole treatment period. Lymphocytes proliferation in response to PHA was significantly higher after 3 months of using the highest dose as compared to the lowest dose. The tuberculin skin test reaction remained persistently negative. We conclude that in a patient with IL-12Rβ1 deficiency, IFN-γ at a dose of 200 μg/m², but not at lower dosages, was found to have a noticeable clinical effect with no additional adverse effects.
- Published
- 2011
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