Polyarthritis associated with hydatid disease (echinococcosis) of the liver

Autoimmunity in human CE: Correlative with the fertility status of the CE cyst

Cystic echinococcosis is speculated to exert several immune-evasion strategies involving autoimmune-phenomena. We evaluated the hypothesizes that the prevalence of autoantibodies increases in the sera of CE patients that may evidence the association between the parasite and autoimmune diseases. Sera from 63 subjects at distinct types of CE cyst fertility were investigated for antinuclear antibodies (ANA), and anti-CCP antibodies. Plasma levels and cellular production of IL-17A cytokine were specifically defined as being assumed to prime for autoimmunity. Healthy-controls were age and gender-matched to test sera. ANA expressions inside the surgically removed metacestode and adventitial layer were also assayed. Out of 63 patients, 35 % had fertile highly viable cysts (group-1), 41 % had fertile low viable cysts (group-2) and 24 % had non-fertile cysts (group-3). A four-fold increase in ANA sera-levels was detected in group-1 compared with their controls (p-value 0.001) while anti-CCP levels were of insignificant differences. In group-2 and group-3, no significant differences were detected between ANA and anti-CCP sera-levels in CE patients and their controls. IL-17A sera-levels in group-1 and group- 2 were significantly higher than their healthy-controls while being of insignificant differences in group-3, p-value= 0.300. No association was detected between sera-levels of IL-17A and ANA as well as anti-CCP antibodies. Interestingly, relative IL-17A cellular expression associated positive ANA deposition in the parasite cells and adventitial layer. Collectively, based on the parasite fertility, IL-17A and ANA seemed to be involved in the host immune defenses against CE. There is no association between CE and anti-CCP antibodies.

Rheumatic manifestations of parasitic diseases

OBJECTIVES

To consolidate the spectrum and frequency of parasite-related rheumatic syndromes, which have largely been regarded as exceedingly rare by the general medicine, infectious disease, and rheumatology literature.

METHODS

A MEDLINE search was performed for articles on rheumatic syndromes related to parasitic infections published from 1966 through December 2000. Identified articles included clinical and epidemiologic studies describing cases of rheumatic syndromes associated with verified parasitic infection.

RESULTS

Rheumatologic syndromes, including inflammatory arthritis, inflammatory myositis, and vasculitis, have been described among multiple different parasite infections of all parasitic divisions, including Protozoa, Nematoda, and Platyhelminthes. Individual parasitic divisions are often associated with particular rheumatic syndromes, such as reactive arthritis and spondyloarthropathy, inflammatory or infectious myositis, and reactive or parainfectious vasculitis.

CONCLUSIONS AND RELEVANCE

Parasitic infection may underlie the clinical presentation of some rheumatic conditions. Given the continued and growing number of patients at risk for parasitosis by virtue of their country of origin, travel habits, and an immunocompromised state, potential parasitosis must be considered in patients undergoing evaluation for rheumatic complaints.