Q-fever and autoimmunity

Eur J Epidemiol. 1989 Dec;5(4):447-53. doi: 10.1007/BF00140139.

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.

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 persistence of clinical or biological findings after three weeks therapy could recommend the use of corticosteroids.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Agglutinins / analysis
  • Anti-Bacterial Agents / therapeutic use
  • Antibodies / analysis
  • Autoantibodies / analysis
  • Autoimmunity*
  • Complement Fixation Tests
  • Cryoglobulins
  • Endocarditis, Bacterial / etiology
  • Female
  • Fluorescent Antibody Technique
  • France
  • Hepatitis / etiology
  • Humans
  • Immunoglobulins / analysis
  • Male
  • Middle Aged
  • Muscle, Smooth / immunology
  • Q Fever / drug therapy
  • Q Fever / immunology*
  • Retrospective Studies

Substances

  • Agglutinins
  • Anti-Bacterial Agents
  • Antibodies
  • Autoantibodies
  • Cryoglobulins
  • Immunoglobulins
  • cold agglutinins