IFNG and retinal dystrophy, optic nerve edema, splenomegaly, anhidrosis, and migraine headache syndrome: Notably, all ROSAH patients who underwent lumbar puncture had elevated CSF neopterin, a marker of IFN-γ–mediated activation of macrophages and astrocytes (Dale et al., 2009; Han et al., 2022; Martin et al., 2025), despite the absence of a strong interferon signature in peripheral blood.