Q-fever presenting as an autoimmune disease: case report and review

Gamaletsou, Maria N.; Gikas, Achilleas; Sipsas, Nikolaos V.

doi:10.2478/s11536-011-0097-y

Cited by 3 publications

(1 citation statement)

References 19 publications

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“…Multiple studies have postulated a close association between Q fever and autoimmune disease [ 5 , 15 ]. A unique manifestation of Q fever is the presence of autoimmune antibodies, including ANA, antiphospholipid antibody, and anti-smooth muscle antibody [ 15 , 16 ]. The presence of these autoimmune biological abnormalities may point toward a vasculitis, systemic inflammatory disease, or autoimmune disease instead of Q fever infection as the diagnosis [ 17 , 18 ].…”

Section: Discussionmentioning

confidence: 99%

Coxiella burnetii Endocarditis in a Patient with Systemic Lupus Erythematosus: A Case Report of a Diagnostic Challenge

Alqallaf

Alhashim

Alajmi³

et al. 2020

Am J Case Rep

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Patient: Male, 43-year-old Final Diagnosis: Q-fever endocarditis Symptoms: Lower limb edema • shortness of breath Medication: — Clinical Procedure: — Specialty: General and Internal Medicine Objective: Rare co-existance of disease or pathology Background: There is a close association between Q fever and autoimmune disease, with some case reports in the literature of Q fever presenting as systemic lupus erythematosus (SLE) and others documenting their coexistence. However, making the correct diagnosis remains challenging and Q fever often is overlooked. Therefore, it is essential to review such a rare presentation to help in accurate diagnosis in future cases. This report is of a case of endocarditis due to Coxiella burnetii in a patient with Q fever and a history of SLE. Case Report: We report the case of a 43-year-old man with a history of SLE and rheumatic heart disease, status post-valve replacement. The patient initially presented with an acute kidney injury in the setting of a history of full-house lupus membranous nephropathy, which was diagnosed on kidney biopsy. The patient had been on immunosuppressive therapy for 2 years. Shortly after he was admitted, echocardiography was ordered because the patient had progressive dyspnea, revealing infective endocarditis involving multiple valves. He underwent valve repair surgery and was placed on an extended course of antibiotic therapy. His symptoms gradually resolved, with normalization of his immunological markers. The patient’s immunosuppressive regimen was eventually discontinued. He remains on lifelong antibiotic suppression therapy. Conclusions: This case highlights the importance of awareness of infectious causes of endocarditis in patients with underlying autoimmune diseases such as SLE. This rare case of C burnetii endocarditis may have been associated with underlying valvular SLE.

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Section: Discussionmentioning

confidence: 99%

Coxiella burnetii Endocarditis in a Patient with Systemic Lupus Erythematosus: A Case Report of a Diagnostic Challenge

Alqallaf

Alhashim

Alajmi³

et al. 2020

Am J Case Rep

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Tick-borne diseases and autoimmunity: A comprehensive review

Rodríguez

Rojas

Gershwin

et al. 2018

Journal of Autoimmunity

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The cellular and humoral immune response against primary infection with Coxiella burnetii

Schoenlaub¹

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Coxiella burnetii is an obligate intracellular bacterial pathogen that causes the disease Q fever in humans. It typically spreads through infectious aerosols generated by ruminants. Cases of Q fever can be found worldwide, but they are particularly common in Australia, the Netherlands, and the Middle East. Acute Q fever is a self-limiting febrile illness, but chronic Q fever develops in some patients. This form of the infection is typically fatal and requires extensive antibiotic treatment. Our research is focused on understanding how the immune system responds to C. burnetii infection. We found important roles for immune cells called T cells and for B cells. T cells are important to clear the infection, while B cells are important in regulating the immune response. We also found that an avirulent form of C. burnetii induces a unique form of cell death in B cells. All studies presented here seek to understand the immune response to Q fever in order to develop new, more effective treatments for acutely and chronically infected patients.

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Q-fever presenting as an autoimmune disease: case report and review

Cited by 3 publications

References 19 publications

Coxiella burnetii Endocarditis in a Patient with Systemic Lupus Erythematosus: A Case Report of a Diagnostic Challenge

Coxiella burnetii Endocarditis in a Patient with Systemic Lupus Erythematosus: A Case Report of a Diagnostic Challenge

Tick-borne diseases and autoimmunity: A comprehensive review

The cellular and humoral immune response against primary infection with Coxiella burnetii

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