Pulmonary Nontuberculous Mycobacterial Disease

作者：Richard D. Kim, David E. Greenberg, Mary Ehrmantraut, Shireen V. Guide, Li Ding, Yvonne R. Shea, Margaret R. Brown, Milica S. Chernick, Wendy K. Steagall, Connie G. Glasgow, Jingping Lin, Clara Jolley, Lynn Sorbara, Mark Raffeld, Suvimol Hill, Nilo A. Avila, Vandana Sachdev, Lisa Barnhart, Victoria Anderson, Reginald J. Claypool, Dianne Hilligoss, Mary Garofalo, Alan Fitzgerald, Sandra Anaya‐O’Brien, Dirk Darnell, Rosamma DeCastro, Heather M. Menning, Stacy Ricklefs, Stephen F. Porcella, Kenneth N. Olivier, Joel Moss, Steven M. Holland · 发表于：American Journal of Respiratory and Critical Care Medicine · 年份：2008 · DOI：10.1164/rccm.200805-686oc · 被引用次数：450 · 研究领域：Mycobacterium research and diagnosis、Immunodeficiency and Autoimmune Disorders、Tuberculosis Research and Epidemiology

RATIONALE: Pulmonary nontuberculous mycobacterial (PNTM) disease is increasing, but predisposing features have been elusive. OBJECTIVES: To prospectively determine the morphotype, immunophenotype, and cystic fibrosis transmembrane conductance regulator genotype in a large cohort with PNTM. METHODS: We prospectively enrolled 63 patients with PNTM infection, each of whom had computerized tomography, echocardiogram, pulmonary function, and flow cytometry of peripheral blood. In vitro cytokine production in response to mitogen, LPS, and cytokines was performed. Anthropometric measurements were compared with National Health and Nutrition Examination Survey (NHANES) age- and ethnicity-matched female control subjects extracted from the NHANES 2001-2002 dataset. MEASUREMENTS AND MAIN RESULTS: Patients were 59.9 (+/-9.8 yr [SD]) old, and 5.4 (+/-7.9 yr) from diagnosis to enrollment. Patients were 95% female, 91% white, and 68% lifetime nonsmokers. A total of 46 were infected with Mycobacterium avium complex, M. xenopi, or M. kansasii; 17 were infected with rapidly growing mycobacteria. Female patients were significantly taller (164.7 vs. 161.0 cm; P < 0.001) and thinner (body mass index, 21.1 vs. 28.2; P < 0.001) than matched NHANES control subjects, and thinner (body mass index, 21.1 vs. 26.8; P = 0.002) than patients with disseminated nontuberculous mycobacterial infection. A total of 51% of patients had scoliosis, 11% pectus excavatum, and 9% mitral valve prolapse, all significantl...