Role of Bartonella henselae in the etiology of Henoch-Schönlein purpura.
BACKGROUND
The etiology of Henoch-Schönlein purpura (HSP) has been ascribed to a variety of infectious and noninfectious agents. Because we encountered a patient with HSP who had evidence of Bartonella henselae infection and a prior report of a patient with systemic cat-scratch disease presenting as leukoclastic vasculitis, we investigated the association of B. henselae infection with HSP.


METHODS
We determined the antibody titers to B. henselae on the sera of 18 patients with HSP and on 57 controls. All patients presented with the characteristic leukoclastic rash of HSP. About one-half of the patients had joint or abdominal symptoms, and four had hematuria at presentation. An indirect immunofluorescent assay was used to determine serum antibody titers to B. henselae. Sera that were reactive at a dilution of 1/64 were considered positive.


RESULTS
Eight of the 57 (14%) control sera and 12 of the 18 (67%) patient sera were positive for B. henselae antibody (P < 0.0001).


CONCLUSIONS
The results of this study indicate a significant association of antecedent B. henselae infection with HSP. The frequency of this association (67%) exceeds that of previously ascribed etiologic agents for this disease, such as the group A Streptococcus.
Ayoub
Elia M
EM
Department of Pediatrics, University of Florida, Gainesville 32610, USA. ayoubem@peds.ufl.edu
McBride
Jason
J
Schmiederer
Michael
M
Anderson
Burt
B
D000293:Adolescent; D016917:Angiomatosis, Bacillary / Q000150:complications*; D000907:Antibodies, Bacterial / Q000032:analysis; D018416:Bartonella henselae / Q000276:immunology / Q000472:pathogenicity*; D002648:Child; D002675:Child, Preschool; D005260:Female; D019084:Fluorescent Antibody Technique, Indirect; D006801:Humans; D011695:IgA Vasculitis / Q000209:etiology / Q000382:microbiology* / Q000473:pathology; D007223:Infant; D008297:Male; D012189:Retrospective Studies; D012307:Risk Factors; D012698:Serologic Tests
D000907:Antibodies, Bacterial