{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,5]],"date-time":"2026-01-05T22:14:57Z","timestamp":1767651297462,"version":"3.44.0"},"reference-count":21,"publisher":"BMJ","issue":"8","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2022,8,17]]},"published-print":{"date-parts":[[2022,8]]},"abstract":"<jats:p>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.<\/jats:p>","DOI":"10.1136\/bcr-2022-250479","type":"journal-article","created":{"date-parts":[[2022,8,23]],"date-time":"2022-08-23T12:15:34Z","timestamp":1661256934000},"page":"e250479","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["Disseminated tuberculosis associated with deficient interleukin-23\/tyrosine kinase 2 signalling"],"prefix":"10.1136","volume":"15","author":[{"given":"Olutobi","family":"Ojuawo","sequence":"first","affiliation":[{"name":"Respiratory Medicine, Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ryan","family":"Allen","sequence":"additional","affiliation":[{"name":"Respiratory Medicine, Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Guy","family":"Hagan","sequence":"additional","affiliation":[{"name":"Respiratory Medicine, Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shahbaz","family":"Piracha","sequence":"additional","affiliation":[{"name":"Respiratory Medicine, Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2022,8,23]]},"reference":[{"unstructured":"World Health Organization . 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