Clinical analysis of nine anti-interferon-γ autoantibody-positive patients with talaromycosis marneffei complicated by Sweet syndrome

Objective To report 9 HIV-negative patients with talaromycosis marneffei (TSM) complicated by Sweet syndrome, and to analyze the relationship of the anti-interferon-γ (anti-IFN-γ) autoantibody with TSM complicated by Sweet syndrome. Methods HIV-negative patients with TSM complicated by Sweet syndrome were collected from the First Affiliated Hospital of Guangxi Medical University between 2013 and 2018. Their clinical and laboratory data were analyzed retrospectively. Meanwhile, 19 HIV-positive patients with TSM and 107 health checkup examinees served as controls. Anti-IFN-γ autoantibody was detected in peripheral blood samples of the patients and controls. Results A total of 9 HIV-negative patients with TSM (5 males and 4 females) were included in this study, and the age of onset ranged from 38 to 60 years. The 9 patients all presented with disseminated infections, manifesting as long-term irregular fever, multiple lymph node enlargement, cough, emaciation and anemia. All of the 9 patients met the diagnostic criteria for classical Sweet syndrome, and microbiological examination of Sweet syndrome lesions was negative. Besides Talaromyces marneffei, 6 patients also were infected with nontuberculous mycobacteria, 4 with varicella-zoster virus, and 2 with Salmonella. All the 9 HIV-negative patients with TSM were positive for anti-IFN-γ autoantibody, while the 107 healthy controls and 19 HIV-positive patients with TSM were negative for anti-IFN-γ autoantibody. Conclusion Anti-IFN-γ autoantibody may be associated with HIV-negative TSM complicated by Sweet syndrome. Key words: Sweet syndrome; Interferon-gamma; HIV; Mycoses; Talaromycosis marneffei