Disseminated tuberculosis associated with deficient interleukin-23/tyrosine kinase 2 signalling.
Allen, Ryan Hagan, Guy Piracha, Shahbaz
Allen, Ryan
Hagan, Guy
Piracha, Shahbaz
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Affiliation
Sandwell and West Birmingham NHS Trust
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Publication date
2022-08-23
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Abstract
Tuberculosis (TB) remains a significant cause of morbidity and mortality globally. The disseminated form of the disease has a worse prognosis and is commonly associated with primary and acquired immunodeficiency states such as HIV/AIDS, post-organ transplant and malnutrition. However, disseminated TB in the context of isolated impaired cellular responses to interleukin (IL)-23 due to tyrosine kinase 2 (TYK2) deficiency has been rarely reported. We highlight the case of a young woman with pulmonary and central nervous system TB associated with previously undiagnosed IL-23/TYK2 signalling defects causing impaired response to IL-23. A significant clinical improvement was observed after introduction of adjunctive interferon-gamma therapy to her anti-tuberculous medications. This case emphasises the need to broadly evaluate for potential immune deficiencies in poorly responding patients with fully sensitive TB as well as the potential benefits of interferon-gamma therapy in patients with certain immune defects.
Citation
Ojuawo, O., Allen, R., Hagan, G., & Piracha, S. (2022). Disseminated tuberculosis associated with deficient interleukin-23/tyrosine kinase 2 signalling. BMJ case reports, 15(8), e250479. https://doi.org/10.1136/bcr-2022-250479
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Article