Clinical manifestations in patients with anti-IFN-γ autoantibodies syndrome and Talaromyces marneffei infection: a prospective cohort study

Abstract Background Anti-interferon-γ autoantibodies syndrome (AIGAs syndrome) is characterized by disseminated infections involving various pathogens. The clinical manifestations of AIGAs syndrome with Talaromyces marneffei (TM) infection are not yet completely understood. Methods A prospective coh...

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Main Authors: Hanlin Liang, Siqiao Liang, Siyao Wu, Ni Chen, Xuemei Huang, Qiangxiu Zeng, Yan Ning, Zengtao Luo, Xiaona Liang, Zhiyi He
Format: Article
Language:English
Published: BMC 2025-02-01
Series:BMC Infectious Diseases
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Online Access:https://doi.org/10.1186/s12879-025-10690-3
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author Hanlin Liang
Siqiao Liang
Siyao Wu
Ni Chen
Xuemei Huang
Qiangxiu Zeng
Yan Ning
Zengtao Luo
Xiaona Liang
Zhiyi He
author_facet Hanlin Liang
Siqiao Liang
Siyao Wu
Ni Chen
Xuemei Huang
Qiangxiu Zeng
Yan Ning
Zengtao Luo
Xiaona Liang
Zhiyi He
author_sort Hanlin Liang
collection DOAJ
description Abstract Background Anti-interferon-γ autoantibodies syndrome (AIGAs syndrome) is characterized by disseminated infections involving various pathogens. The clinical manifestations of AIGAs syndrome with Talaromyces marneffei (TM) infection are not yet completely understood. Methods A prospective cohort study was conducted at the First Affiliated Hospital of Guangxi Medical University from January 2021 to February 2024. Patients diagnosed with TM infection were categorized into two groups: AIGAs-positive with TM infection group (Group 1) and AIGAs-negative with TM infection group (Group 2). We analyzed the clinical manifestations, laboratory data, imaging findings, and pathological characteristics of the patients to gain insights into the disease’s clinical features. Results A total of 80 AIGAs-positive patients with TM infection (Group 1) and 23 AIGAs-negative patients with TM infection (Group 2) were enrolled. Disseminated infection was significantly more common among Group 1 patients (P < 0.001). Patients in Group 1 had higher serum G test levels than those in Group 2 (P < 0.001). They also showed higher levels of white blood cells, neutrophils, lymphocytes, eosinophils, monocytes, C-reactive protein, erythrocyte sedimentation rate, serum ferritin, globulin, immunoglobulin (Ig)G, IgE, and IgG4 (P < 0.05). Common infection sites included the lungs, lymph nodes, bones, skin, and blood in Group 1 patients. Coinfections were frequently with cytomegalovirus (CMV) and non-tuberculous mycobacteria (NTM). Among patients with bone involvement, 92.6% had systemic involvement, while 7.14% had localized involvement. Chest CT, bronchoscopy, and pathology presentations were varied. During a mean 26-month follow-up, 63.63% of patients had exacerbations; 44.9% due to reactivation of the original pathogen and 55.1% due to new pathogen infections. The multivariable Cox regression analysis indicated that dyspnea and bloodstream infection are significant risk factors for the exacerbation of AIGAs-Positive Patients with TM Infection (P < 0.05). Conclusions AIGAs-positive patients with TM infection showed elevated inflammatory markers, abnormal immune indices, increased serum G test levels, and disseminated infections involving multiple organs. The most common coinfections were CMV and NTM. Chest imaging, bronchoscopy, and pathological findings can present diversity.
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spelling doaj-art-a755263f2e334acda871aecbb89755fc2025-08-20T02:16:48ZengBMCBMC Infectious Diseases1471-23342025-02-0125111210.1186/s12879-025-10690-3Clinical manifestations in patients with anti-IFN-γ autoantibodies syndrome and Talaromyces marneffei infection: a prospective cohort studyHanlin Liang0Siqiao Liang1Siyao Wu2Ni Chen3Xuemei Huang4Qiangxiu Zeng5Yan Ning6Zengtao Luo7Xiaona Liang8Zhiyi He9Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Guangxi Medical UniversityDepartment of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Guangxi Medical UniversityDepartment of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Guangxi Medical UniversityDepartment of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Guangxi Medical UniversityDepartment of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Guangxi Medical UniversityDepartment of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Guangxi Medical UniversityDepartment of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Guangxi Medical UniversityDepartment of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Guangxi Medical UniversityDepartment of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Guangxi Medical UniversityDepartment of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Guangxi Medical UniversityAbstract Background Anti-interferon-γ autoantibodies syndrome (AIGAs syndrome) is characterized by disseminated infections involving various pathogens. The clinical manifestations of AIGAs syndrome with Talaromyces marneffei (TM) infection are not yet completely understood. Methods A prospective cohort study was conducted at the First Affiliated Hospital of Guangxi Medical University from January 2021 to February 2024. Patients diagnosed with TM infection were categorized into two groups: AIGAs-positive with TM infection group (Group 1) and AIGAs-negative with TM infection group (Group 2). We analyzed the clinical manifestations, laboratory data, imaging findings, and pathological characteristics of the patients to gain insights into the disease’s clinical features. Results A total of 80 AIGAs-positive patients with TM infection (Group 1) and 23 AIGAs-negative patients with TM infection (Group 2) were enrolled. Disseminated infection was significantly more common among Group 1 patients (P < 0.001). Patients in Group 1 had higher serum G test levels than those in Group 2 (P < 0.001). They also showed higher levels of white blood cells, neutrophils, lymphocytes, eosinophils, monocytes, C-reactive protein, erythrocyte sedimentation rate, serum ferritin, globulin, immunoglobulin (Ig)G, IgE, and IgG4 (P < 0.05). Common infection sites included the lungs, lymph nodes, bones, skin, and blood in Group 1 patients. Coinfections were frequently with cytomegalovirus (CMV) and non-tuberculous mycobacteria (NTM). Among patients with bone involvement, 92.6% had systemic involvement, while 7.14% had localized involvement. Chest CT, bronchoscopy, and pathology presentations were varied. During a mean 26-month follow-up, 63.63% of patients had exacerbations; 44.9% due to reactivation of the original pathogen and 55.1% due to new pathogen infections. The multivariable Cox regression analysis indicated that dyspnea and bloodstream infection are significant risk factors for the exacerbation of AIGAs-Positive Patients with TM Infection (P < 0.05). Conclusions AIGAs-positive patients with TM infection showed elevated inflammatory markers, abnormal immune indices, increased serum G test levels, and disseminated infections involving multiple organs. The most common coinfections were CMV and NTM. Chest imaging, bronchoscopy, and pathological findings can present diversity.https://doi.org/10.1186/s12879-025-10690-3Anti-interferon-γ autoantibodiesTalaromyces marneffeiClinical manifestations
spellingShingle Hanlin Liang
Siqiao Liang
Siyao Wu
Ni Chen
Xuemei Huang
Qiangxiu Zeng
Yan Ning
Zengtao Luo
Xiaona Liang
Zhiyi He
Clinical manifestations in patients with anti-IFN-γ autoantibodies syndrome and Talaromyces marneffei infection: a prospective cohort study
BMC Infectious Diseases
Anti-interferon-γ autoantibodies
Talaromyces marneffei
Clinical manifestations
title Clinical manifestations in patients with anti-IFN-γ autoantibodies syndrome and Talaromyces marneffei infection: a prospective cohort study
title_full Clinical manifestations in patients with anti-IFN-γ autoantibodies syndrome and Talaromyces marneffei infection: a prospective cohort study
title_fullStr Clinical manifestations in patients with anti-IFN-γ autoantibodies syndrome and Talaromyces marneffei infection: a prospective cohort study
title_full_unstemmed Clinical manifestations in patients with anti-IFN-γ autoantibodies syndrome and Talaromyces marneffei infection: a prospective cohort study
title_short Clinical manifestations in patients with anti-IFN-γ autoantibodies syndrome and Talaromyces marneffei infection: a prospective cohort study
title_sort clinical manifestations in patients with anti ifn γ autoantibodies syndrome and talaromyces marneffei infection a prospective cohort study
topic Anti-interferon-γ autoantibodies
Talaromyces marneffei
Clinical manifestations
url https://doi.org/10.1186/s12879-025-10690-3
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