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


METHODS
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.


METHODS
French National Reference Center for Rickettsial Diseases.


METHODS
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.


RESULTS



METHODS
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.


CONCLUSIONS
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 persistence of clinical or biological findings after three weeks therapy could recommend the use of corticosteroids.
Levy
P
P
Centre National de Reference des Rickettsies, Groupe hospitalier de la Timone, Marseille, France.
Raoult
D
D
Razongles
J J
JJ
D000328:Adult; D000373:Agglutinins / Q000032:analysis; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000906:Antibodies / Q000032:analysis; D001323:Autoantibodies / Q000032:analysis; D015551:Autoimmunity; D003168:Complement Fixation Tests; D003450:Cryoglobulins; D004697:Endocarditis, Bacterial / Q000209:etiology; D005260:Female; D005455:Fluorescent Antibody Technique; D005602:France; D006505:Hepatitis / Q000209:etiology; D006801:Humans; D007136:Immunoglobulins / Q000032:analysis; D008297:Male; D008875:Middle Aged; D009130:Muscle, Smooth / Q000276:immunology; D011778:Q Fever / Q000188:drug therapy / Q000276:immunology*; D012189:Retrospective Studies
D000373:Agglutinins; D000900:Anti-Bacterial Agents; D000906:Antibodies; D001323:Autoantibodies; D003450:Cryoglobulins; D007136:Immunoglobulins; C029443:cold agglutinins