Anticytokine autoantibodies (AAbs), particularly anti-interferon-gamma (anti-IFN-γ) AAbs, disrupt cytokine functions, leading to infections, autoimmune-like diseases, and conditions resembling interleukin-12 (IL-12)/IFN-γ pathway defects. Advances in genetic testing have clarified overlaps between autoinflammatory, autoimmune disorders, and primary immunodeficiencies but reveal complex phenotypes and pathways. While these insights deepen our understanding of immune mechanisms, they also complicate diagnosis and treatment, with limited options for IFN-γ deficiencies caused by genetic mutations. The adult-onset immunodeficiency with disseminated lymphadenitis due to nontuberculous mycobacteria (NTM) and other opportunistic infections has been linked to high levels of anti-IFN-γ AAbs. This syndrome, initially identified in HIV-negative Asian patients, frequently affects individuals of Asian descent and may be associated with specific human leukocyte antigen (HLA) alleles. The presence of neutralizing anti-IFN-γ AAbs impairs the IFN-γ-dependent immune response, likely contributing to the persistent NTM infection. This study underscores the potential for late-onset anti-IFN-γ AAb syndrome to manifest with disseminated NTM (dNTM) infections, highlights the importance of timely diagnosis and considers rituximab as a potential therapeutic option.

Background: The best practices for childhood allergy prevention are continually evolving. We do not know the optimal frequency for continued exposure of common allergenic foods after the initial introduction into a child’s diet. Home-based oral immunotherapy is a promising treatment avenue for childhood food allergies. Case presentation: We describe the case of a child who was tolerating wheat and underwent a 2-week unintentional deprivation period wherein they were not exposed to any wheat. After this period, they experienced an anaphylactic reaction to wheat upon re-introduction. The child had a history of other allergies for which they were receiving oral immunotherapy and they now are receiving oral immunotherapy for wheat as well. Conclusions: Our case is unique as, to the best of our knowledge, there has yet to be a case published wherein a deprivation period as short as 2 weeks has resulted in an anaphylactic reaction, despite previous tolerance of the allergen. Clearer labelling of gluten free versus gluten-containing products as confusion regarding labelling contributed to the unintentional deprivation period is needed. Families should also be counselled on thorough food product label reading. Finally, further research is warranted regarding the optimal frequency of potential allergen dietary reintroduction.

Introduction. Exercise interventions may assist smoking cessation attempts. One such publicly available 10-week program, Walk or Run to Quit (WRTQ), demonstrated success in smoking cessation and physical activity (PA) outcomes. However, initial WRTQ participants (2016-2017) were fairly homogenous in their demographic profile. To increase diversity, subsidies for participation were offered in 2018. This study assessed how the subsidies affected participant demographics, running frequency, smoking cessation, intention to quit, and program attendance and completion. Methods. The $70 registration fee was subsidized for 41% of participants in 2018. A pre-postdesign was used, with participants completing surveys on their demographics and smoking and physical activity behaviours. Descriptive statistics compared the year subsidies were available (2018) and unsubsidized years (2016-2017) and subsidized and unsubsidized participants’ data from 2018. Results. The 2018 participants had lower average attendance and program completion rates compared to 2016-2017 and no statistically significant differences in demographics or smoking cessation and PA outcomes. There were no differences in smoking cessation, run frequency, or demographic variables between the subsidized and unsubsidized participants in 2018. Conclusions. Offering subsidies did not diversify the participant profile. Subsidies did not have a negative impact on attendance nor primary outcomes. Subsidies may not have addressed barriers that prevented a more diverse sample from participating in WRTQ, such as program location, timing, and design. Equitable access to smoking cessation programs remains essential. As subsidies may play a role in reducing financial barriers disproportionately faced by marginalized groups, the implementation of, and recruitment for, such subsidized programs requires further investigation.

Background: Pitaya, commonly known as dragon fruit, is increasingly available and has allergenic potential. Pollens have been found to have cross-reactivity and thus induce allergies to several fruits, however, to our knowledge this is first report of pitaya anaphylaxis in a patient without co-sensitization to other fruit or environmental allergens. Case presentation: A 26-year-old male presented to the emergency department with anaphylaxis after consumption of pitaya (dragon fruit). He had no prior history of atopy. Epicutaneous skin testing demonstrated positive to pitaya and negative to all other cross-reactive food and environmental allergens, suggesting his pitaya allergy did not derive from cross-sensitization. Conclusions: Our case is unique in demonstrating the potential for pitaya allergy to occur independent of other allergies and cross-sensitization. Future research is warranted into suspected allergenic proteins in pitaya and quantifying their structural similarity to other known allergens.