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Q-fever and autoimmunity

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Abstract

Study objective: To determine the incidence and the clinical significance of two autoimmune markers in Q-fever (smooth muscle antibodies, cold agglutinins).

Design: Six index cases with auto-immune disorders.

Assays of 104 sera from patients with Q-fever (including index cases) using immunofluorescence for smooth muscle antibodies, microagglutination for cold agglutinins.

Setting: French National Reference Center for Rickettsial Diseases.

Cases: 6 patients were studied with acute Q-fever and auto-immune disorders. 3 of whom had presented a resistance to a therapy with antibiotics. Stored samples from other patients with acute or chronic stage were also screened to appreciate the incidence of the two markers.

Measurements and main results: Case reports: No correlation between Q-fever and smooth muscle antibodies titers and kinetics were found.

A spurt of corticosteroids was necessary to obtain apyrexia for the patients who had presented multiple auto-immune disorders and a resistance to the classical therapy.

Incidence: Smooth muscle antibodies were detected in 27%, cold agglutinins in one case. They were present in 23% of the patients with acute cases and in 38% with chronic stage.

Conclusion: The incidence of auto-immune disorders is unexpectedly high and could explain some manifestations of acute Q-fever e.g the resistance to therapy with antibiotics which are not yet clear. Then the association during the acute stage of auto-immune disorders with the persistance of clinical or biological findings after three weeks therapy could recommend the use of corticosteroids.

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Authors and Affiliations

  1. Centre National de Reference des Rickettsies (D. Raoult), Groupe hospitalier de la Timone, Boulevard J. Moulin, 13385, Marseille cedex 5, France

    P. Levy & D. Raoult

  2. Centre Regional de Transfusion Sanguine, Boulevard Baille, 13385, Marseille cedex 5, France

    J. J. Razongles

Authors
  1. P. Levy
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  2. D. Raoult
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  3. J. J. Razongles
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Levy, P., Raoult, D. & Razongles, J.J. Q-fever and autoimmunity. Eur J Epidemiol 5, 447–453 (1989). https://doi.org/10.1007/BF00140139

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