{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T13:35:57Z","timestamp":1791293757104,"version":"4.1.0"},"reference-count":26,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2021,10,27]],"date-time":"2021-10-27T00:00:00Z","timestamp":1635292800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"DOI":"10.13039\/501100004663","name":"Ministry of Science and Technology, Taiwan","doi-asserted-by":"publisher","award":["MOST 106\u20132314-B-002\u2013214"],"award-info":[{"award-number":["MOST 106\u20132314-B-002\u2013214"]}],"id":[{"id":"10.13039\/501100004663","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004663","name":"Ministry of Science and Technology, Taiwan","doi-asserted-by":"publisher","award":["MOST 107\u20132314-B-002\u2013209-MY3"],"award-info":[{"award-number":["MOST 107\u20132314-B-002\u2013209-MY3"]}],"id":[{"id":"10.13039\/501100004663","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004663","name":"Ministry of Science and Technology, Taiwan","doi-asserted-by":"publisher","award":["110\u20132314-B-002\u2013247-"],"award-info":[{"award-number":["110\u20132314-B-002\u2013247-"]}],"id":[{"id":"10.13039\/501100004663","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,8,25]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Neutralizing anti\u2013granulocyte-macrophage colony-stimulating factor (GM-CSF) autoantibodies (AAbs) have been increasingly recognized to predispose healthy individuals to disseminated cryptococcosis. However, studies have only considered patients with central nervous system (CNS) infection. No longitudinal study has captured the disease spectrum and clinical course.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We prospectively enrolled adults without human immunodeficiency virus infection who had disseminated or unusual cryptococcosis. We compared the demographics, clinical features, kinetics of serum cryptococcal antigen (CrAg) titers, anti\u2013GM-CSF AAb concentrations, and treatment outcomes between patients with (case patients) and without (control patients) anti\u2013GM-CSF AAbs. Additional reports from the literature were also reviewed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Twenty-three patients were enrolled, of whom 6 tested positive for anti\u2013GM-CSF AAbs. All case patients with positive fungal cultures (5\/5 [100%]) were infected with Cryptococcus gattii VGII. Among them, 3 had exclusively pulmonary involvement, and 1 had only musculoskeletal lesions. Patients with CNS cryptococcosis exhibited a higher serum concentration of anti\u2013GM-CSF AAbs than those with extraneural cryptococcosis. Case patients had higher initial and peak levels of serum CrAg and longer duration of antigenemia compared with the control patients. All case patients who had completed antifungal therapy had favorable outcomes without recurrence.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Testing for anti\u2013GM-CSF AAbs should be considered for not only previously healthy patients with disseminated cryptococcosis but also those with unexplained, localized cryptococcosis. Recurrence after completion of antifungal therapy was rare despite the persistence of anti\u2013GM-CSF AAbs.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/cid\/ciab920","type":"journal-article","created":{"date-parts":[[2021,10,25]],"date-time":"2021-10-25T15:13:11Z","timestamp":1635174791000},"page":"278-287","source":"Crossref","is-referenced-by-count":26,"title":["Neutralizing Anti\u2013Granulocyte-Macrophage Colony-Stimulating Factor Autoantibodies in Patients With Central Nervous System and Localized Cryptococcosis: Longitudinal Follow-up and Literature Review"],"prefix":"10.1093","volume":"75","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1729-790X","authenticated-orcid":false,"given":"Po Hsien","family":"Kuo","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine , Taipei , Taiwan"},{"name":"Department of Internal Medicine, National Taiwan University Hospital, Hsin-Chu Branch , Hsin-Chu , Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Un In","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine , Taipei , Taiwan"},{"name":"Department of Medicine, National Taiwan University Cancer Center , Taipei , Taiwan and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi Hua","family":"Pan","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine , Taipei , Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jann Tay","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine , Taipei , Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu Chen","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Medical Imaging, National Taiwan University Hospital , Taipei , Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hsin Yun","family":"Sun","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine , Taipei , Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wang Huei","family":"Sheng","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine , Taipei , Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yee Chun","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine , Taipei , Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shan Chwen","family":"Chang","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine , Taipei , Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2021,10,27]]},"reference":[{"key":"2022082520482559900_CIT0001","doi-asserted-by":"crossref","first-page":"3","DOI":"10.3390\/antib5010003","article-title":"Anticytokine autoantibodies: association with infection and immune dysregulation.","volume":"5","author":"Knight","year":"2016","journal-title":"Antibodies (Basel)"},{"key":"2022082520482559900_CIT0002","doi-asserted-by":"crossref","first-page":"528","DOI":"10.1136\/thx.2005.054171","article-title":"Clinical significance of anti-GM-CSF antibodies in idiopathic pulmonary alveolar 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