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Article ; Online: Cutaneous presentation of disseminated cytomegalovirus infection in a non-transplant patient with hematological malignancy: A case report.

Yu, Hung-Chuan / Liu, Wang-Da / Kuo, Po-Hsien / Lin, Chien-Chin / Wu, Un-In

2022 Volume 101, Issue 5, Page(s) e28721

Abstract: Rationale: Cytomegalovirus (CMV) disease is relatively uncommon in nontransplant hematological patients. Moreover, cutaneous manifestations of CMV diseases have scarcely been reported and are probably under-recognized.: Patient concerns: We describe ... ...

Abstract	Rationale: Cytomegalovirus (CMV) disease is relatively uncommon in nontransplant hematological patients. Moreover, cutaneous manifestations of CMV diseases have scarcely been reported and are probably under-recognized. Patient concerns: We describe a patient with large B-cell lymphoma who developed a band-form, erythematous lesion over his left abdomen soon after the second course of rituximab, cyclophosphamide, doxorubicin, vincristine, prednisolone chemotherapy. Diagnoses: The lesion was initially mistaken for bacterial cellulitis or herpes zoster and was histologically confirmed as cutaneous CMV infection. Subsequent work-up also detected CMV viremia and the presence of CMV meningoencephalitis. Interventions: The patient was treated with ganciclovir plus CMV immune globulin followed by foscarnet. Outcomes: Although the patient's cutaneous lesion resolved, his cognitive impairment did not recover, and he developed a fatal multi-organ failure 1 month later. Lessons: Cutaneous CMV disease can herald multisystem involvement and an unfavorable prognosis in immunocompromised hosts. It should be ruled out with biopsy in patients with hematological malignancy who have cutaneous lesions refractory to antibacterial therapy.
MeSH term(s)	Antiviral Agents/therapeutic use ; Cytomegalovirus Infections/diagnosis ; Cytomegalovirus Infections/drug therapy ; Fatal Outcome ; Foscarnet/therapeutic use ; Ganciclovir/therapeutic use ; Hematologic Neoplasms/drug therapy ; Humans ; Immunocompromised Host ; Male ; Skin Diseases/drug therapy ; Skin Diseases/virology
Chemical Substances	Antiviral Agents ; Foscarnet (364P9RVW4X) ; Ganciclovir (P9G3CKZ4P5)
Language	English
Publishing date	2022-02-23
Publishing country	United States
Document type	Case Reports ; Journal Article
ZDB-ID	80184-7
ISSN	1536-5964 ; 0025-7974
ISSN (online)	1536-5964
ISSN	0025-7974
DOI	10.1097/MD.0000000000028721
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Article ; Online: How long should we treat Candida albicans pyomyositis? Insight from a cured case.

Yang, Hung-Wei / Wu, Un-In / Hsieh, Jung-Hsien / Tai, Hao-Chih

Journal of microbiology, immunology, and infection = Wei mian yu gan ran za zhi

2020 Volume 53, Issue 4, Page(s) 665–667

MeSH term(s)	Antifungal Agents/therapeutic use ; Arm/microbiology ; Arm/pathology ; Candida albicans/drug effects ; Candida albicans/isolation & purification ; Candidiasis/diagnosis ; Candidiasis/therapy ; Debridement ; Humans ; Male ; Middle Aged ; Pyomyositis/diagnosis ; Pyomyositis/therapy ; Recurrence ; Time Factors ; Treatment Outcome
Chemical Substances	Antifungal Agents
Language	English
Publishing date	2020-02-13
Publishing country	England
Document type	Case Reports ; Letter
ZDB-ID	1497590-7
ISSN	1995-9133 ; 1684-1182 ; 0253-2662
ISSN (online)	1995-9133
ISSN	1684-1182 ; 0253-2662
DOI	10.1016/j.jmii.2020.02.004
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Article ; Online: A genetic perspective on granulomatous diseases with an emphasis on mycobacterial infections.

Wu, Un-In / Holland, Steven M

Seminars in immunopathology

2016 Volume 38, Issue 2, Page(s) 199–212

Abstract: Identification of the genetic factors predisposing to mycobacterial infections has been a subject of intense research activities. Current knowledge of the genetic and immunological basis of susceptibility to mycobacteria largely comes from natural human ... ...

Abstract	Identification of the genetic factors predisposing to mycobacterial infections has been a subject of intense research activities. Current knowledge of the genetic and immunological basis of susceptibility to mycobacteria largely comes from natural human and experimental models of Bacille Calmette Guérin (BCG) and nontuberculous mycobacterial infections. These observations support the central role of the IL-12/IFN-γ pathway in controlling mycobacterial infection. In this review, we discuss the knowledge that associates both simple and complex inheritance with susceptibility to mycobacterial diseases. We place a special emphasis on monogenic disorders, since these clearly pinpoint pathways and can adduce mechanism. We also describe the clinical, immunological, and pathological features that may steer clinical investigation in the appropriate directions.
MeSH term(s)	Animals ; Genetic Association Studies ; Genetic Diseases, Inborn/complications ; Genetic Diseases, Inborn/genetics ; Genetic Diseases, Inborn/metabolism ; Genetic Predisposition to Disease ; Granuloma/etiology ; Granuloma/metabolism ; Granuloma/pathology ; Host-Pathogen Interactions/genetics ; Host-Pathogen Interactions/immunology ; Humans ; Immune System/immunology ; Immune System/metabolism ; Immune System/microbiology ; Immune System/pathology ; Interferon-gamma/deficiency ; Interferon-gamma/genetics ; Interferon-gamma/metabolism ; Interleukin-12/deficiency ; Interleukin-12/genetics ; Interleukin-12/metabolism ; Mycobacterium/immunology ; Mycobacterium Infections/complications ; Mycobacterium Infections/genetics ; Mycobacterium Infections/immunology ; Mycobacterium Infections/microbiology ; Risk Factors ; Sequence Deletion ; Signal Transduction
Chemical Substances	Interleukin-12 (187348-17-0) ; Interferon-gamma (82115-62-6)
Language	English
Publishing date	2016-01-05
Publishing country	Germany
Document type	Journal Article ; Research Support, N.I.H., Intramural ; Review
ZDB-ID	2316828-6
ISSN	1863-2300 ; 1863-2297
ISSN (online)	1863-2300
ISSN	1863-2297
DOI	10.1007/s00281-015-0552-y
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Zs.A 1425: Show issues

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Article ; Online: Disseminated Mycobacterium chimaera infection in a patient with adult-onset immunodeficiency syndrome: case report.

Lin, Yi-Fu / Lee, Tai-Fen / Wu, Un-In / Huang, Chun-Fu / Cheng, Aristine / Lin, Kuan-Yin / Hung, Chien-Ching

BMC infectious diseases

2022 Volume 22, Issue 1, Page(s) 665

Abstract: Background: Patients with adult-onset immunodeficiency syndrome due to anti-interferon-γ autoantibodies (AIGAs) are susceptible to disseminated Mycobacterium avium complex (MAC) infections. M. chimaera, a newly identified MAC species, is distinguished ... ...

Abstract	Background: Patients with adult-onset immunodeficiency syndrome due to anti-interferon-γ autoantibodies (AIGAs) are susceptible to disseminated Mycobacterium avium complex (MAC) infections. M. chimaera, a newly identified MAC species, is distinguished from the others due to the reduced virulence. Previous cases of disseminated M. chimaera infection have been linked to cardiothoracic surgery. Reports of disseminated M. chimaera in patients without a history of cardiothoracic surgery are rare. Case presentation: A 57-year-old Asian man, previously healthy, presented with fever, dry cough, exertional dyspnea, and decreased appetite. The delayed resolution of pneumonia despite antibiotic treatment prompted further imaging studies and biopsies from the lung and lymph node. The fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) demonstrated intense uptake in lung consolidations and diffuse lymphadenopathy. Cultures of the specimens obtained from sputum, blood, stool, lung tissue, and lymph node grew M. chimaera. Further immunological evaluation disclosed the presence of neutralizing AIGAs, which possibly led to acquired immunodeficiency and disseminated M. chimaera infection. Conclusions: We herein present the first case of adult-onset immunodeficiency due to AIGAs complicated with disseminated M. chimaera infection. Further immunological evaluation, including AIGAs, may be warranted in otherwise healthy patients who present with disseminated mycobacterial infection.
MeSH term(s)	Adult ; Chimera ; Humans ; Immunologic Deficiency Syndromes/complications ; Male ; Middle Aged ; Mycobacterium ; Mycobacterium Infections, Nontuberculous/microbiology ; Positron Emission Tomography Computed Tomography
Language	English
Publishing date	2022-08-01
Publishing country	England
Document type	Case Reports ; Journal Article
ZDB-ID	2041550-3
ISSN	1471-2334 ; 1471-2334
ISSN (online)	1471-2334
ISSN	1471-2334
DOI	10.1186/s12879-022-07656-0
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Article ; Online: A difficult-to-treat pleuropulmonary histoplasmosis in a patient with rheumatoid arthritis in Taiwan.

Chu, Wen-Kai / Wu, Un-In / Lee, Tai-Fen / Cheng, Aristine / Chen, Kai-Hsiang / Lin, Kuan-Yin / Chen, Yee-Chun

Journal of microbiology, immunology, and infection = Wei mian yu gan ran za zhi

2022 Volume 56, Issue 1, Page(s) 192–196

Abstract: Amphotericin B and itraconazole are the primary agents for treating histoplasmosis. Newer azoles are alternatives for patients refractory to or intolerant of standard therapy. We report an 83-year-old woman with rheumatoid arthritis complicated with ... ...

Abstract	Amphotericin B and itraconazole are the primary agents for treating histoplasmosis. Newer azoles are alternatives for patients refractory to or intolerant of standard therapy. We report an 83-year-old woman with rheumatoid arthritis complicated with pleuropulmonary histoplasmosis who responded to liposomal amphotericin B, but progressed under voriconazole and posaconazole maintenance therapy.
MeSH term(s)	Female ; Humans ; Aged, 80 and over ; Histoplasmosis/complications ; Histoplasmosis/diagnosis ; Histoplasmosis/drug therapy ; Antifungal Agents/therapeutic use ; Taiwan ; Histoplasma ; Arthritis, Rheumatoid/complications ; Arthritis, Rheumatoid/drug therapy
Chemical Substances	Antifungal Agents
Language	English
Publishing date	2022-12-13
Publishing country	England
Document type	Case Reports ; Journal Article
ZDB-ID	1497590-7
ISSN	1995-9133 ; 1684-1182 ; 0253-2662
ISSN (online)	1995-9133
ISSN	1684-1182 ; 0253-2662
DOI	10.1016/j.jmii.2022.12.005
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Zs.B 2083: Show issues

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Article ; Online: Host susceptibility to non-tuberculous mycobacterial infections.

Wu, Un-In / Holland, Steven M

The Lancet. Infectious diseases

2015 Volume 15, Issue 8, Page(s) 968–980

Abstract: Non-tuberculous mycobacteria cause a broad range of clinical disorders, from cutaneous infections, such as cervical or intrathoracic lymphadenitis in children, to disseminated infections at all ages. Recognition of the underlying immune defect is crucial ...

Abstract	Non-tuberculous mycobacteria cause a broad range of clinical disorders, from cutaneous infections, such as cervical or intrathoracic lymphadenitis in children, to disseminated infections at all ages. Recognition of the underlying immune defect is crucial for rational treatment, preventive care, family screening, and, in some cases, transplantation. So far, at least seven autosomal mutations (in IL12B, IL12RB1, ISG15, IFNGR1, IFNGR2, STAT1, and IRF8) and two X-linked mutations (in IKBKG and CYBB), mostly presenting in childhood, have been reported to confer susceptibility to disseminated non-tuberculous mycobacterial infection. GATA2 deficiency and anti-interferon γ autoantibodies also give rise to disseminated infection, typically in late childhood or adulthood. Furthermore, isolated pulmonary non-tuberculous mycobacterial infection has been increasing in prevalence in people without recognised immune dysfunction. In this Review, we discuss how to detect and differentiate host susceptibility factors underlying localised and systemic non-tuberculous mycobacterial infections.
MeSH term(s)	Genetic Predisposition to Disease/genetics ; Humans ; Mutation/genetics ; Mycobacterium Infections, Nontuberculous/genetics
Language	English
Publishing date	2015-08
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Intramural ; Review
ZDB-ID	2061641-7
ISSN	1474-4457 ; 1473-3099
ISSN (online)	1474-4457
ISSN	1473-3099
DOI	10.1016/S1473-3099(15)00089-4
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Zs.A 5743: Show issues

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Article: Video-assisted thoracoscopic surgery for primary pulmonary cryptococcosis.

Lu, Chao-Wen / Liu, Wang-Da / Hsu, Hsao-Hsun / Wu, Un-In / Jeng, Yung-Ming / Chen, Yee-Chun / Chen, Jin-Shing

Journal of the Formosan Medical Association = Taiwan yi zhi

2022 Volume 121, Issue 11, Page(s) 2237–2247

Abstract: Background: The surgical outcome for primary pulmonary cryptococcosis remains unclear. In this study, we investigated the clinical characteristics, treatment, and outcomes of video-assisted thoracoscopic surgery (VATS) for primary pulmonary ... ...

Abstract	Background: The surgical outcome for primary pulmonary cryptococcosis remains unclear. In this study, we investigated the clinical characteristics, treatment, and outcomes of video-assisted thoracoscopic surgery (VATS) for primary pulmonary cryptococcosis. Methods: We retrospectively reviewed the medical records of 49 patients with confirmed pulmonary cryptococcosis who underwent VATS for pulmonary nodules at the National Taiwan University Hospital between May 2013 and March 2019. Serum cryptococcal antigen (CryAg)-positive and CryAg-negative patients were compared. Results: The diagnosis of pulmonary cryptococcosis was confirmed using histopathology or tissue swab culture. The mean age of the patients was 56.0 ± 12.2 years, and 27 patients (55.1%) were male. Most patients were asymptomatic (67.3%) and admitted following the detection of pulmonary lesions on a computed tomography scan of the chest. A greater proportion of patients in the CryAg-positive group (62.5%) underwent lobectomy compared with those in the CryAg-negative group (7.3%, P < 0.001). Three patients (6.1%) had neurological symptoms (headache or dizziness) and all were serum CryAg-positive. One patient with Cryptococcus gattii developed fluctuating serum CryAg titers after a 12-month antifungal treatment. No relapse occurred in the remaining 48 patients, irrespective of postoperative antifungal treatment. Conclusion: In patients with primary pulmonary cryptococcosis, serum CryAg detection rate is low, and VATS was an effective and safe diagnostic and therapeutic tool.
MeSH term(s)	Adult ; Aged ; Antifungal Agents/therapeutic use ; Antigens, Fungal ; Cryptococcosis/diagnosis ; Cryptococcosis/drug therapy ; Cryptococcosis/surgery ; Female ; Humans ; Male ; Middle Aged ; Neoplasm Recurrence, Local ; Retrospective Studies ; Thoracic Surgery, Video-Assisted/methods
Chemical Substances	Antifungal Agents ; Antigens, Fungal
Language	English
Publishing date	2022-04-30
Publishing country	Singapore
Document type	Journal Article
ZDB-ID	2096659-3
ISSN	1876-0821 ; 0929-6646
ISSN (online)	1876-0821
ISSN	0929-6646
DOI	10.1016/j.jfma.2022.04.014
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Zs.B 1041: Show issues

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Article ; Online: Anti-IFN-γ Immunodeficiency Syndrome Presenting as Blurred Vision and Salmonellosis.

Peng, Shu-Yu / Chen, Ta-Ching / Wu, Un-In / Huang, Chien-Jung / Ho, Tzyy-Chang

Journal of clinical immunology

2020 Volume 41, Issue 1, Page(s) 274–276

MeSH term(s)	Adult ; Autoantibodies/immunology ; Autoimmunity ; Diagnosis, Differential ; Disease Susceptibility ; Female ; Fluorescein Angiography ; Humans ; Immunologic Deficiency Syndromes/diagnosis ; Immunologic Deficiency Syndromes/etiology ; Immunologic Deficiency Syndromes/therapy ; Immunosuppressive Agents/administration & dosage ; Immunosuppressive Agents/therapeutic use ; Interferon-gamma/immunology ; Salmonella Infections/diagnosis ; Salmonella Infections/therapy ; Symptom Assessment ; Treatment Outcome ; Vision, Low/diagnosis ; Vision, Low/therapy
Chemical Substances	Autoantibodies ; Immunosuppressive Agents ; Interferon-gamma (82115-62-6)
Language	English
Publishing date	2020-11-06
Publishing country	Netherlands
Document type	Case Reports ; Letter
ZDB-ID	779361-3
ISSN	1573-2592 ; 0271-9142
ISSN (online)	1573-2592
ISSN	0271-9142
DOI	10.1007/s10875-020-00900-9
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Zs.A 1640: Show issues

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Article ; Online: Association of vaccine-specific regulatory T cells with reduced antibody response to repeated influenza vaccination.

Lin, Pin-Hung / Hsiao, Po-Ju / Pan, Ching-Fu / Liu, Ming-Tsan / Wang, Jann-Tay / Ching, Chi / Wu, Fang-Yi / Lin, Yi-Hsuan / Yang, Yu-Chan / Hsu, Le-Yin / Yang, Hung-Chih / Wu, Un-In

European journal of immunology

2023 Volume 53, Issue 12, Page(s) e2350525

Abstract: Repeated annual influenza vaccinations have been associated with reduced vaccine-induced antibody responses. This prospective study aimed to explore the role of vaccine antigen-specific regulatory T (Treg) cells in antibody response to repeated annual ... ...

Abstract	Repeated annual influenza vaccinations have been associated with reduced vaccine-induced antibody responses. This prospective study aimed to explore the role of vaccine antigen-specific regulatory T (Treg) cells in antibody response to repeated annual influenza vaccination. We analyzed pre- and postvaccination hemagglutination inhibition (HI) titers, seroconversion rates, seroprotection rates, vaccine antigen hemagglutinin (HA)-specific Treg cells, and conventional T (Tconv) cells. We compared these parameters between vaccinees with or without vaccine-induced seroconversion. Our multivariate logistic regression revealed that prior vaccination was significantly associated with a decreased likelihood of achieving seroconversion for both H1N1(adjusted OR, 0.03; 95% CI, 0.01-0.13) and H3N2 (adjusted OR, 0.09; 95% CI, 0.03-0.30). Furthermore, individuals who received repeated vaccinations had significantly higher levels of pre-existing HA-specific Treg cells than those who did not. We also found that vaccine-induced fold-increases in HI titers and seroconversion were negatively correlated with pre-existing HA-specific Treg cells and positively correlated with the ratio of Tconv to Treg cells. Overall, our findings suggest that repeated annual influenza vaccination is associated with a lower vaccine-induced antibody response and a higher frequency of vaccine-specific Treg cells. However, a lower frequency of pre-existing Treg cells correlates with a higher postvaccination antibody response.
MeSH term(s)	Humans ; Influenza, Human/prevention & control ; Influenza Vaccines ; T-Lymphocytes, Regulatory ; Antibody Formation ; Influenza A Virus, H1N1 Subtype ; Influenza A Virus, H3N2 Subtype ; Prospective Studies ; Antibodies, Viral ; Vaccination ; Hemagglutination Inhibition Tests
Chemical Substances	Influenza Vaccines ; Antibodies, Viral
Language	English
Publishing date	2023-09-29
Publishing country	Germany
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	120108-6
ISSN	1521-4141 ; 0014-2980
ISSN (online)	1521-4141
ISSN	0014-2980
DOI	10.1002/eji.202350525
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Zs.A 489: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (1.OG) ab Jg. 2022: Lesesaal (EG)
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Article ; Online: CXCL9 as a Reliable Biomarker for Discriminating Anti-IFN-γ-Autoantibody-Associated Lymphadenopathy that Mimics Lymphoma.

Yuan, Chang-Tsu / Huang, Wan-Ting / Hsu, Chia-Lang / Wang, Hsuan / Pan, Yi-Hua / Wu, Un-In / Wang, Jann-Tay / Sheng, Wang-Huei / Chen, Yee-Chun / Chang, Shan-Chwen

Journal of clinical immunology

2023 Volume 44, Issue 1, Page(s) 35

Abstract: The diagnosis of adult-onset immunodeficiency syndrome associated with neutralizing anti-interferon γ autoantibodies (AIGA) presents substantial challenges to clinicians and pathologists due to its nonspecific clinical presentation, absence of routine ... ...

Abstract	The diagnosis of adult-onset immunodeficiency syndrome associated with neutralizing anti-interferon γ autoantibodies (AIGA) presents substantial challenges to clinicians and pathologists due to its nonspecific clinical presentation, absence of routine laboratory tests, and resemblance to certain lymphoma types, notably nodal T follicular helper cell lymphoma, angioimmunoblastic type (nTFHL-AI). Some patients undergo lymphadenectomy for histopathological examination to rule out lymphoma, even in the absence of a preceding clinical suspicion of AIGA. This study aimed to identify reliable methods to prevent misdiagnosis of AIGA in this scenario through a retrospective case-control analysis of clinical and pathological data, along with immune gene transcriptomes using the NanoString nCounter platform, to compare AIGA and nTFHL-AI. The investigation revealed a downregulation of the C-X-C motif chemokine ligand 9 (CXCL9) gene in AIGA, prompting an exploration of its diagnostic utility. Immunohistochemistry (IHC) targeting CXCL9 was performed on lymph node specimens to assess its potential as a diagnostic biomarker. The findings exhibited a significantly lower density of CXCL9-positive cells in AIGA compared to nTFHL-AI, displaying a high diagnostic accuracy of 92.3% sensitivity and 100% specificity. Furthermore, CXCL9 IHC demonstrated its ability to differentiate AIGA from various lymphomas sharing similar characteristics. In conclusion, CXCL9 IHC emerges as a robust biomarker for differentiating AIGA from nTFHL-AI and other similar conditions. This reliable diagnostic approach holds the potential to avert misdiagnosis of AIGA as lymphoma, providing timely and accurate diagnosis.
MeSH term(s)	Adult ; Humans ; Retrospective Studies ; Lymphadenopathy ; Lymphoma/diagnosis ; Autoantibodies ; Biomarkers ; Chemokine CXCL9
Chemical Substances	Autoantibodies ; Biomarkers ; CXCL9 protein, human ; Chemokine CXCL9
Language	English
Publishing date	2023-12-28
Publishing country	Netherlands
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	779361-3
ISSN	1573-2592 ; 0271-9142
ISSN (online)	1573-2592
ISSN	0271-9142
DOI	10.1007/s10875-023-01643-z
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