Mycobacterium avium Complex Pleuritis with Elevated Anti-glycopeptidolipid-core IgA Antibody Levels in Pleural Effusion

Koji Furuuchi; Kozo Morimoto; Keiji Fujiwara; Yoshiaki Tanaka; Tamiko Takemura; Atsuyuki Kurashima; Kozo Yoshimori; Ken Ohta; Yuka Sasaki

doi:10.2169/internalmedicine.2751-19

CASE REPORTS

Mycobacterium avium Complex Pleuritis with Elevated Anti-glycopeptidolipid-core IgA Antibody Levels in Pleural Effusion

Koji Furuuchi, Kozo Morimoto, Keiji Fujiwara, Yoshiaki Tanaka, Tamiko Takemura, Atsuyuki Kurashima, Kozo Yoshimori, Ken Ohta, Yuka Sasaki

Author information

Koji Furuuchi
Respiratory Disease Center, Fukujuji Hospital, Japan Anti-Tuberculosis Association, Japan
Kozo Morimoto
Respiratory Disease Center, Fukujuji Hospital, Japan Anti-Tuberculosis Association, Japan
Division of Clinical Research, Fukujuji Hospital, Japan Anti-Tuberculosis Association, Japan
Keiji Fujiwara
Respiratory Disease Center, Fukujuji Hospital, Japan Anti-Tuberculosis Association, Japan
Yoshiaki Tanaka
Respiratory Disease Center, Fukujuji Hospital, Japan Anti-Tuberculosis Association, Japan
Tamiko Takemura
Department of Pathology, Japan Red Cross Hospital Medical Center, Japan
Atsuyuki Kurashima
Respiratory Disease Center, Fukujuji Hospital, Japan Anti-Tuberculosis Association, Japan
Kozo Yoshimori
Respiratory Disease Center, Fukujuji Hospital, Japan Anti-Tuberculosis Association, Japan
Ken Ohta
Respiratory Disease Center, Fukujuji Hospital, Japan Anti-Tuberculosis Association, Japan
Yuka Sasaki
Respiratory Disease Center, Fukujuji Hospital, Japan Anti-Tuberculosis Association, Japan

Keywords: Mycobacterium avium complex, pleural effusion, glycopeptidolipid

JOURNAL OPEN ACCESS

2019 Volume 58 Issue 17 Pages 2577-2579

DOI https://doi.org/10.2169/internalmedicine.2751-19

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Abstract

Pleuritis caused by nontuberculous mycobacteria is uncommon and difficult to diagnose. We herein report a case of Mycobacterium avium complex (MAC) pleuritis with elevated anti-glycopeptidolipid (GPL)-core IgA antibody levels in the pleural effusion. A 73-year-old woman with MAC pulmonary disease presented with massive left pleural effusion. A pleural biopsy by video-assisted thoracoscopic surgery was performed, revealing many noncaseating epithelioid cell granulomas. MAC was not identified by culture of the pleural effusion or specimens, but the anti-GPL-core IgA antibody level was markedly elevated in the pleural effusion. Measurement of anti-GPL-core IgA levels in the pleural fluid may be useful for diagnosing MAC pleuritis.

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