Antinuclear antibodies in infectious diseases

Im, Jae Hyoung; Chung, Moon-Hyun; Park, Young Kyoung; Kwon, Hea Yoon; Baek, Ji Hyeon; Lee, Seung Yun; Lee, Jin Soo

doi:10.1080/23744235.2019.1690676

Cited by 49 publications

(28 citation statements)

References 28 publications

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“…Remarkably, we did not detect any association of ANAs with female gender or with age in our cohort, even though it is generally known that ANAs occur more frequently in women and in the elderly [40]. Therefore, our data support the hypothesis that the occurrence of these unspecific autoantibodies represents a para-infectious phenomenon, caused mainly by a misdirected immune response, and that it should not be seen as the initial step in the development of de novo autoimmune diseases [41,42]. This phenomenon should trigger tests to determine HEV-RNA in any patients with acute hepatitis [15,16,18], in order to prevent potential false diagnosis of AIH, due to high ANA rates among HEV infected patients.…”

Section: Discussionsupporting

confidence: 57%

Significance of Anti-Nuclear Antibodies and Cryoglobulins in Patients with Acute and Chronic HEV Infection

et al. 2020

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Background: Hepatitis E virus (HEV) has been associated with immunological phenomena. Their clinical significance, however, still needs to be clarified, that is, whether cryoglobulins or autoantibodies impact overt disease in HEV-infected individuals. To better understand, we analyzed these different immune phenomena in three cohorts, each representing different types of HEV infection. Methods: The cohorts included: (i) immunocompetent patients with acute hepatitis E, (ii) immunosuppressed patients with chronic hepatitis E, and (iii) individuals with asymptomatic HEV infection. Together, they consisted of 57 individuals and were studied retrospectively for the presence of anti-nuclear antibodies (ANAs), cryoglobulins, and serum total IgG. They were then compared with a control cohort of 17 untreated patients with chronic hepatitis B virus (HBV) infection or hepatitis C virus (HCV) infection. Results: Thirteen (23%) were immunocompetent patients with acute hepatitis E (median alanine aminotransferase (ALT) = 872 U/L), 15 (26%) were immunosuppressed patients with chronic hepatitis E (median ALT = 137 U/L), and 29 (51%) were blood donors with asymptomatic HEV infection (median ALT = 35 U/L). Overall, 24% tested positive for elevated ANA titers of >1:160, and 11% presented with a specific ANA pattern. ANA detection was not associated with the type of HEV infection, IgG levels, sex, or age. All individuals tested negative for anti-mitochondrial antibodies, anti-neutrophil cytoplasmic antibodies, liver-kidney microsomal antibodies, anti-myeloperoxidase-, and anti-proteinase-3 antibodies. Five patients (9%) tested positive for cryoglobulins. Notably, cryoglobulinemia was present in overt hepatitis E (Groups (i) and (ii); one acute and four chronic HEV infections), but was not present in any of the asymptomatic blood donors (p = 0.02). The frequency of cryoglobulins and elevated ANAs did not differ significantly between HEV and HBV/HCV patients. Conclusion: In line with findings on HBV and HCV infections, we frequently observed detection of ANAs (24%) and cryoglobulins (9%) in association with HEV infections. The presence of cryoglobulins was limited to patients with overt hepatitis E. We add to the findings on the immune phenomena of hepatitis E.

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Section: Discussionsupporting

confidence: 57%

Significance of Anti-Nuclear Antibodies and Cryoglobulins in Patients with Acute and Chronic HEV Infection

et al. 2020

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“…Our systematic review of the literature identified 56 articles (including our series) evaluating 1020 patients (Table 1, WHOLE cohort) between 1 December 2019 and 9 of May 2020. [2][3][4][5][6][7][8][9][10] Diagnosis of COVID-19 infection was confirmed in 47% of patients (Table 1, CONFIRMED cohort). The female-tomale ratio was 1.1 in both cohorts.…”

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confidence: 99%

Relapsing symmetric livedo reticularis in a patient with COVID‐19 infection

Verheyden

Grosber

Gutermuth

et al. 2020

Acad Dermatol Venereol

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During the Coronavirus 2019 (COVID‐19) pandemic, several associated skin conditions were reported in infected patients, including; urticaria [1], exanthema [1], erythema multiforme [2], chickenpox‐like vesicles [1], pityriasis rosea [3], herpes simplex reactivation [4], erythema nodosum like Sweet’s syndrome [5], Symmetrical Drug‐Related Intertriginous and Flexural Exanthema [6], petechial rash [7], vasculitic purpura [7], acro‐ischemia/necrosis [8], Kawasaki disease [2] and chilblain lesions [9].

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“…Patients with connective tissue disorders may develop SI as a result of vasculitis, splenomegaly, and antiphospholipid syndrome (22). Infections in patients with vasculitis are generally believed to be secondary to an immunocompromised status; nevertheless, the possibility of infection exacerbating connective tissue diseases should also be taken into consideration [23]. Exacerbation of atherosclerosis due to infection is sometimes ignored in clinical practice.…”

Section: Discussionmentioning

confidence: 99%

Splenic Infarction and Infectious Diseases in Korea

Chung²,

Lee

et al. 2020

Preprint

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BackgroundThe spleen contains immune cells and exhibits a pattern of infarction different from other organs; as such, splenic infarction (SI) may provide important clues to infection. However, the nature of the relationship between SI and infectious disease(s) is not well understood. Accordingly, this retrospective study investigated the relationship between SI and infection. MethodsHospital records of patients with SI, who visited Inha University Hospital (Incheon, Republic of Korea) between January 2008 and December 2018, were reviewed. Patient data regarding clinical presentation, causative pathogens, risk factors, and radiological findings were collected and analyzed.ResultsOf 353 patients with SI, 101 with infectious conditions were enrolled in this study, and their data were analyzed to identify associations between SI and infection. Ten patients were diagnosed with infective endocarditis (IE), and 26 exhibited bacteremia without IE. Twenty-seven patients experienced systemic infection due to miscellaneous causes (negative result on conventional automated blood culture), including the following intracellular organisms: parasites (malaria [n =12], babesiosis [n =1]); bacteria (scrub typhus [n =5]); viruses (Epstein–Barr [n =1], cytomegalovirus [n =1]); and unidentified pathogen[s] (n =7). Splenomegaly was more common among patients with miscellaneous systemic infection; infarction involving other organs was rare. Thirty-eight patients had localized infections (e.g., respiratory, intra-abdominal, or skin and soft tissue infection), and most (35 of 38) had other risk factors for SI. ConclusionsIn this study, various infectious conditions were found to be associated with SI, and intracellular organisms were the most common causative pathogens. Further studies are needed to examine other possible etiologies and the underlying pathophysiological mechanisms.

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Antinuclear antibodies in infectious diseases

Cited by 49 publications

References 28 publications

Significance of Anti-Nuclear Antibodies and Cryoglobulins in Patients with Acute and Chronic HEV Infection

Significance of Anti-Nuclear Antibodies and Cryoglobulins in Patients with Acute and Chronic HEV Infection

Relapsing symmetric livedo reticularis in a patient with COVID‐19 infection

Splenic Infarction and Infectious Diseases in Korea

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