title: Serological follow-up in patients with aorto-iliac disease and evidence of Q fever infection.
abstract: The aim of this study was to provide data on the risk of developing chronic Q fever in patients with aorto-iliac disease and evidence of previous Q fever infection. Patients with an aortic and/or iliac aneurysm or aorto-iliac reconstruction (aorto-iliac disease) and evidence of previous Q fever infection were included. The presence of phase I and II Coxiella burnetii IgG antibodies was assessed periodically using immunofluorescence assay. A total of 111 patients with aorto-iliac disease were divided into three groups, based upon the serological profile [mean follow-up: 16 ± 9 months (mean ± standard deviation)]. Group 1 consisted of 30 patients with a serological trace of C. burnetii infection (negative IgG phase I, IgG phase II titer of 1:32). Of these, 36.7% converted to serological profile matching past resolved Q fever. Group 2 included 49 patients with negative IgG phase I titer and IgG phase II titer ≥1:64. No patients developed chronic Q fever, but 14.3% converted to a positive IgG phase I titer. Group 3 consisted of 32 patients with positive IgG phase I and positive IgG phase II titers, of which 9.4% developed chronic Q fever (significantly different from group 2, p = 0.039). The IgG phase I titer increased in 28.1% of patients (from 1:64 to 1:4,096). The risk of developing chronic Q fever in patients with aorto-iliac disease and previous Q fever infection with a positive IgG phase I titer was 9.4%. The IgG phase I titer increases or becomes positive in a substantial number of patients. A standardized serological follow-up is proposed.
authors.affiliation: Department of Surgery, Jeroen Bosch Hospital, P.O. Box 90153, 5200 ME, 's-Hertogenbosch, The Netherlands, j.c.j.p.hagenaars@gmail.com.
authors.forename: J C J P
authors.initials: JC
authors.lastname: Hagenaars
authors.forename: N H M
authors.initials: NH
authors.lastname: Renders
authors.forename: A S
authors.initials: AS
authors.lastname: van Petersen
authors.forename: S O A
authors.initials: SO
authors.lastname: Shamelian
authors.forename: M G L
authors.initials: MG
authors.lastname: de Jager-Leclercq
authors.forename: F L
authors.initials: FL
authors.lastname: Moll
authors.forename: P C
authors.initials: PC
authors.lastname: Wever
authors.forename: O H J
authors.initials: OH
authors.lastname: Koning
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000907:Antibodies, Bacterial / Q000097:blood; D001014:Aortic Aneurysm / Q000097:blood / Q000276:immunology* / Q000382:microbiology; D016997:Coxiella burnetii / Q000276:immunology*; D005260:Female; D006801:Humans; D017543:Iliac Aneurysm / Q000097:blood / Q000276:immunology* / Q000382:microbiology; D007074:Immunoglobulin G / Q000097:blood; D008297:Male; D011778:Q Fever / Q000097:blood / Q000175:diagnosis* / Q000276:immunology; D012307:Risk Factors
chemical_list: D000907:Antibodies, Bacterial; D007074:Immunoglobulin G