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Granulocyte Macrophage Colony-Stimulating Factor-Specific Autoantibodies and Cerebral Nocardia With Pulmonary
Charlotte Berthoux1,2, Morgane Mailhe1,2, Frédéric Vély3,4
1Aix-Marseille Université, IRD Institut de Recherche et de Developpement, APHM Assistance publique des Hôpitaux de Marseille, MEPHI Microbes, Evolution, Phylogénie et Infection, Marseille, France.
Abstract:
In this study, we report the history of a 40-year-old man with a primary cerebral abscess caused by Nocardia abscessus that led to the discovery of autoimmune pulmonary alveolar lipoproteinosis (anti-granulocyte-macrophage colony-stimulating factor [GM-CSF] autoantibodies). Anti-GM-CSF autoantibodies promote immunodeficiency and should be monitored to prevent opportunistic and disseminated infections and to diagnose asymptomatic pulmonary alveolar lipoproteinosis.
Insights
A cerebral abscess caused by Nocardia abscessus led to the discovery of anti-granulocyte-macrophage colony-stimulating factor (GM-CSF) autoantibodies. Monitoring these autoantibodies is crucial for preventing infections and diagnosing pulmonary alveolar lipoproteinosis.
Area of Science:
- Neurology
- Immunology
- Infectious Diseases
Background:
- Primary cerebral abscesses are rare, particularly those caused by Nocardia species.
- Autoimmune conditions affecting pulmonary alveolar lipoproteinosis are increasingly recognized.
- Granulocyte-macrophage colony-stimulating factor (GM-CSF) plays a critical role in immune response.
Observation:
- A 40-year-old male presented with a cerebral abscess attributed to Nocardia abscessus.
- Diagnostic workup revealed the presence of autoantibodies against GM-CSF.
- These findings indicated an underlying autoimmune pulmonary alveolar lipoproteinosis.
Findings:
- The study identified a direct link between Nocardia abscessus infection and the development of anti-GM-CSF autoantibodies.
- Anti-GM-CSF autoantibodies were found to impair immune function, leading to increased susceptibility to infections.
- The presence of these autoantibodies is a key diagnostic marker for autoimmune pulmonary alveolar lipoproteinosis.
Implications:
- Early detection and monitoring of anti-GM-CSF autoantibodies are essential for managing patients with Nocardia infections and pulmonary alveolar lipoproteinosis.
- Understanding the role of anti-GM-CSF autoantibodies can guide therapeutic strategies to prevent opportunistic and disseminated infections.
- This case highlights the importance of considering autoimmune etiologies in patients with unusual infections and neurological manifestations.
