{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T17:03:00Z","timestamp":1793293380033,"version":"4.5.0"},"reference-count":28,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T00:00:00Z","timestamp":1782172800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\n                      Anti\u2013interferon-\u03b3 autoantibody-associated adult-onset immunodeficiency is a rare acquired immunodeficiency that predisposes patients to recurrent or disseminated opportunistic infections, particularly nontuberculous mycobacterial (NTM) infections. Disseminated\n                      <jats:italic>Mycobacterium kansasii<\/jats:italic>\n                      infection in this setting is uncommon and may radiologically mimic malignancy, leading to diagnostic delay.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case presentation<\/jats:title>\n                    <jats:p>\n                      A 53-year-old Chinese man with untreated chronic hepatitis B virus (HBV) infection presented with cough, chest pain, and back pain. Chest computed tomography and ^18F-FDG PET\/CT revealed a left hilar mass, mediastinal and hilar lymphadenopathy, and extensive FDG-avid skeletal lesions, initially suggesting lung cancer with bone metastases. However, repeated pathological examinations, including bronchoscopic brushing, endobronchial ultrasound-guided transbronchial needle aspiration, and cervical lymph node aspiration, failed to confirm malignancy. Targeted next-generation sequencing of bronchoalveolar lavage fluid and metagenomic next-generation sequencing of vertebral tissue both identified\n                      <jats:italic>Mycobacterium kansasii<\/jats:italic>\n                      , supporting disseminated infection with pulmonary and skeletal involvement. Subsequent immunologic testing demonstrated elevated anti\u2013IFN-\u03b3 autoantibodies, supporting a clinical diagnosis of AIGA-associated disseminated\n                      <jats:italic>M. kansasii<\/jats:italic>\n                      infection. Antimycobacterial therapy was initiated, but further treatment was complicated by postoperative cholestatic jaundice and high-level HBV viremia, which precluded immediate escalation to immune-directed therapy.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      AIGA-associated disseminated\n                      <jats:italic>Mycobacterium kansasii<\/jats:italic>\n                      infection can closely mimic lung cancer with bone metastases. In patients with tumor-like pulmonary and skeletal lesions but repeatedly nondiagnostic pathology, early integration of pathogen detection and anti\u2013IFN-\u03b3 autoantibody testing may help shorten diagnostic delay.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fimmu.2026.1841472","type":"journal-article","created":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T04:34:07Z","timestamp":1782189247000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Disseminated Mycobacterium kansasii infection with osseous involvement in anti-interferon-\u03b3 autoantibody-associated adult-onset immunodeficiency: a case report and literature review"],"prefix":"10.3389","volume":"17","author":[{"given":"Jian","family":"Wang","sequence":"first","affiliation":[{"name":"Department of Gastroenterology, Jiaxing Second Hospital","place":["Jiaxing, Zhejiang, 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