PMC6791407_01
(A-D) 2014-9-9 chest CT showed patchy infiltration in the left lower lobe in lung window and lymph nodes enlargement in mediastinal window (arrows); (E-H) 2016-8-27 chest CT showed the alveolar consolidation in left upper lobe (arrows), the anterior chest wall with rib destruction (arrows); (I-L) 2017-5-8 chest CT showed improvement of pulmonary lesion and rib destruction after treatment (arrows).
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Laboratory tests showed increased white cells and chest computed tomography (CT) suggested patchy infiltration in the left lower lobe, with mediastinal lymph node enlargement (Figure 1A-D). Chest CT (2016-8-27) showed alveolar consolidation in the anterior segment of the left upper lobe, and an anterior chest wall with rib destruction and multiple lymphadenopathies in the left axillary and mediastinum (Figure 1E-H). The patient was followed up regularly in the clinic (Figure 1I-L).
(A-C) 2018-5-8 chest CT showed right upper lobe consolidation and destruction of the left sternoclavicular joint (arrows); (D-F) 2019-06-04 chest CT showed gradually absorption of pulmonary consolidation but remains of bone destruction and lymphadenopathy after treatment (arrows).
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Her body temperature peaked at 40 C with increased pulmonary infiltration accompanied by left sternoclavicular joint destruction (Figure 2A-C). Bone destruction and lymphadenopathy, however, remained obvious (Figure 2D-F).
(A) The erythematous painful papules in patient's hands; (B, C) pathological examination of HE staining (HEx100; HEx400) from the hand skin lesion showed dermal florid full-thickness suppurative inflammation.
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Physical examinations revealed multiple palpable lymph nodes in the left neck, erythematous plaques, and nodules in both hands (Figure 3A). Histopathology of the hand skin showed neutrophil infiltration (Figure 3B and C).
After treatment, level of Immunoglobin G remained high (normal range 7.51-15.6 g/L).
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Laboratory tests were in the normal range except for IgG (Figure 4).
Anti-Interferon-gamma autoantibodies concentration in serum, the patient (range: 33.13-47.06 ng/mL) was 2.85-fold to healthy subjects (anti-IFN-gamma-autoAbs). ***P<0.001.
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The mean concentration of anti-IFN-gamma antibodies in the serum samples of the patient (range: 33.13-47.06 ng/mL) was 2.85-fold higher than healthy subjects (range: 8.41-20.02 ng/mL) (P<0.01) (Figure 5).