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Elghali M, Bannour I, Touil I, Changuel M, Brahem Y, Jaoued O, Boudawara N, Amor HIH, Elatrous S, Knani J, Sakly N. Increased Rheumatoid Factor production in patients with severe COVID-19. Diagn Microbiol Infect Dis 2024; 109:116284. [PMID: 38604077 DOI: 10.1016/j.diagmicrobio.2024.116284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 03/13/2024] [Accepted: 03/21/2024] [Indexed: 04/13/2024]
Abstract
BACKGROUND Searching for Rheumatoid Factors (RF) in patients with coronavirus disease (COVID-19) has rarely been described. OBJECTIVES To investigate the association between RF isotypes (IgM, IgA, and IgG) and different clinical presentations of COVID-19 in a series of Tunisian patients. STUDY DESIGN Eighty-two COVID-19 patients were enrolled in this study. Symptomatic cases were recruited from the Department of COVID-19 and the intensive care unit (ICU) of the University Hospital of Mahdia, Tunisia, from January 2021 to March 2021. Different RF isotypes were assessed using a commercial enzyme-linked immunosorbent assay (ELISA). RESULTS Forty-one patients (50%) had RF of any isotype. Thirty-two patients (39%) were tested positive for RF-IgM. Symptomatic forms of the disease were associated with RF-IgM positivity (p = 0.005). The mean concentration of RF-IgM was higher in the severe form than in the moderate and asymptomatic forms (p = 0.006). CONCLUSIONS Our study suggests that the production of RF-IgM isotype is increased in patients with severe COVID-19.
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Affiliation(s)
- Mourad Elghali
- Immunology department, University Hospital F.B., University of Monastir, Monastir, Tunisia
| | - I Bannour
- Immunology department, University Hospital F.B., University of Monastir, Monastir, Tunisia
| | - I Touil
- Pneumology department, Tahar Sfar hospital, University of Monastir, Mahdia, Tunisia
| | - M Changuel
- Immunology department, University Hospital F.B., University of Monastir, Monastir, Tunisia
| | - Y Brahem
- Pneumology department, Tahar Sfar hospital, University of Monastir, Mahdia, Tunisia
| | - O Jaoued
- Intensive Care Unit, Tahar Sfar hospital, University of Monastir, Mahdia, Tunisia
| | - N Boudawara
- Pneumology department, Tahar Sfar hospital, University of Monastir, Mahdia, Tunisia
| | - H Ibn Hadj Amor
- Cardiology Department, Tahar Sfar hospital, University of Monastir, Mahdia, Tunisia
| | - S Elatrous
- Intensive Care Unit, Tahar Sfar hospital, University of Monastir, Mahdia, Tunisia
| | - J Knani
- Pneumology department, Tahar Sfar hospital, University of Monastir, Mahdia, Tunisia
| | - N Sakly
- Immunology department, University Hospital F.B., University of Monastir, Monastir, Tunisia.
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Songtanin B, Chaisrimaneepan N, Mendóza R, Nugent K. Burden, Outcome, and Comorbidities of Extrahepatic Manifestations in Hepatitis B Virus Infections. Viruses 2024; 16:618. [PMID: 38675959 PMCID: PMC11055091 DOI: 10.3390/v16040618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2024] [Revised: 04/11/2024] [Accepted: 04/13/2024] [Indexed: 04/28/2024] Open
Abstract
Hepatitis B virus (HBV) infections affect approximately 296 million people around the world, and the prevalence of any past or present HBV infection during the years 2015-2018 was as high as 4.3%. Acute HBV infection often presents with nonspecific symptoms and is usually self-limited, but 5% of patients can have persistent infections leading to chronic HBV infection and the risk of turning into chronic HBV infection is significantly higher in babies with vertical transmission (95%). Patients with chronic HBV infection are usually asymptomatic, but 15 to 40% of chronic HBV carriers develop cirrhosis and/or hepatocellular carcinoma. In addition to liver-related disorders, HBV is also associated with several extrahepatic complications, including glomerulonephritis, cryoglobulinemia, neurologic disorders, psychological manifestations, polyarthritis, and dermatologic disorders. Making the diagnosis of HBV can be challenging since patients with chronic infections can remain symptom-free for decades before developing cirrhosis or hepatocellular carcinoma, and patients with acute HBV infection may have only mild, nonspecific symptoms. Therefore, understanding how this virus causes extrahepatic complications can help clinicians consider this possibility in patients with diverse symptom presentations. The pathophysiology of these extrahepatic disorders likely involves immune-related tissue injury following immune complex formation and inflammatory cascades. In some cases, direct viral infection of extrahepatic tissue may cause a clinical syndrome. Currently, the American Association for the Study of Liver Diseases recommends treatment of chronic HBV infections with interferon therapy and/or nucleos(t)ide analogs, and this treatment has been reported to improve some extrahepatic disorders in some patients with chronic HBV infection. These extrahepatic complications have a significant role in disease outcomes and increase medical costs, morbidity, and mortality. Therefore, understanding the frequency and pathogenesis of these extrahepatic complications provides important information for both specialists and nonspecialists and may help clinicians identify patients at an earlier stage of their infection.
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Affiliation(s)
- Busara Songtanin
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA (K.N.)
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Avila-Trejo AM, Rodríguez-Páez LI, Alcántara-Farfán V, Aguilar-Faisal JL. Multiple Factors Involved in Bone Damage Caused by Chikungunya Virus Infection. Int J Mol Sci 2023; 24:13087. [PMID: 37685893 PMCID: PMC10488091 DOI: 10.3390/ijms241713087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 08/21/2023] [Accepted: 08/22/2023] [Indexed: 09/10/2023] Open
Abstract
Chronic cases of chikungunya fever represent a public health problem in countries where the virus circulates. The disease is prolonged, in some cases, for years, resulting in disabling pain and bone erosion among other bone and joint problems. As time progresses, tissue damage is persistent, although the virus has not been found in blood or joints. The pathogenesis of these conditions has not been fully explained. Additionally, it has been considered that there are multiple factors that might intervene in the viral pathogenesis of the different conditions that develop. Other mechanisms involved in osteoarthritic diseases of non-viral origin could help explain how damage is produced in chronic conditions. The aim of this review is to analyze the molecular and cellular factors that could be involved in the tissue damage generated by different infectious conditions of the chikungunya virus.
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Affiliation(s)
- Amanda M. Avila-Trejo
- Laboratorio de Bioquímica Farmacológica, Departamento de Bioquímica, Escuela Nacional de Ciencias Biológicas, Instituto Politécnico Nacional, Mexico City 11340, Mexico; (A.M.A.-T.); (L.I.R.-P.); (V.A.-F.)
- Laboratorio de Medicina de Conservación, Secretaría de Estudios de Posgrado e Investigación, Escuela Superior de Medicina, Instituto Politécnico Nacional, Mexico City 11340, Mexico
| | - Lorena I. Rodríguez-Páez
- Laboratorio de Bioquímica Farmacológica, Departamento de Bioquímica, Escuela Nacional de Ciencias Biológicas, Instituto Politécnico Nacional, Mexico City 11340, Mexico; (A.M.A.-T.); (L.I.R.-P.); (V.A.-F.)
| | - Verónica Alcántara-Farfán
- Laboratorio de Bioquímica Farmacológica, Departamento de Bioquímica, Escuela Nacional de Ciencias Biológicas, Instituto Politécnico Nacional, Mexico City 11340, Mexico; (A.M.A.-T.); (L.I.R.-P.); (V.A.-F.)
| | - J. Leopoldo Aguilar-Faisal
- Laboratorio de Medicina de Conservación, Secretaría de Estudios de Posgrado e Investigación, Escuela Superior de Medicina, Instituto Politécnico Nacional, Mexico City 11340, Mexico
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Kötter I, Krusche M. [Inflammatory rheumatic diseases in migrants]. INNERE MEDIZIN (HEIDELBERG, GERMANY) 2023; 64:426-434. [PMID: 37099225 DOI: 10.1007/s00108-023-01514-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Accepted: 04/04/2023] [Indexed: 04/27/2023]
Abstract
The immigration of people from other countries or even from other continents represents new challenges even for rheumatologists. Although all inflammatory rheumatic diseases that occur in this country also exist in the countries of origin of immigrants, the frequencies are different. Diseases such as familial Mediterranean fever (FMF) or Behçet syndrome (BS) are rare in western Europe but are often more frequent than rheumatoid arthritis (RA) and spondylarthritis (SPA) in North Africa and Mediterranean countries. Furthermore, FMF is associated with the occurrence of spondyloarthritis, which is then frequently negative for the human leucocyte antigen B27 (HLA-B27). There is also an association with BS. Rheumatic fever also still occurs relatively frequently especially in African countries, whereas it is almost eradicated in Europe. Possible differential diagnoses such as rheumatic symptoms in genetically determined anemia or infections such as human immunodeficiency virus (HIV) infections, hepatitis, tuberculosis and parasitosis need to be considered as they are all much more frequent in the countries of origin of immigrants than in northwestern Europe. Last but not least, the treatment situation with modern diagnostic and treatment modalities is different in the countries of origin of the migrants, either because these possibilities are unavailable due to limited resources or because the situation has dramatically deteriorated due to acute events, such as the recent war in Ukraine.
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Affiliation(s)
- Ina Kötter
- III. Medizinische Klinik, Sektion für Rheumatologie und Entzündliche Systemerkrankungen, Universitätsklinikum Eppendorf, Martinistr. 52, 20246, Hamburg, Deutschland.
- Klinik für Rheumatologie und Immunologie, Klinikum Bad Bramstedt, Oskar-Alexander Str. 26, 24576, Bad Bramstedt, Deutschland.
| | - Martin Krusche
- III. Medizinische Klinik, Sektion für Rheumatologie und Entzündliche Systemerkrankungen, Universitätsklinikum Eppendorf, Martinistr. 52, 20246, Hamburg, Deutschland
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Sahoo RR, Wakhlu A, Agarwal V. Neglected tropical rheumatic diseases. Clin Rheumatol 2022; 41:1293-1304. [PMID: 35142903 DOI: 10.1007/s10067-022-06090-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 01/30/2022] [Accepted: 01/31/2022] [Indexed: 12/11/2022]
Abstract
The complexities of dealing with rheumatic diseases in tropical countries are diverse and likely due to limited health care infrastructure, lack of diagnostic and therapeutic facilities, impact of dominant prevailing diseases, and the challenges of differentiating from infectious and non-infectious disease mimics. Several tropical diseases present with musculoskeletal and rheumatic manifestations and often pose a diagnostic dilemma to rheumatologists. The diagnosis is often delayed or the disease is misdiagnosed, leading to poor patient outcomes. Endemic tropical diseases like tuberculosis and leprosy have myriad rheumatic presentations and remain important differentials to consider in patients with rheumatic manifestations. Infection with human immunodeficiency virus is a great masquerade and can mimic manifestations of multiple diseases. The role of viral infections in triggering and perpetuating autoimmunity is well known and chikungunya arthritis is a classic example of the same. This review highlights the rheumatic manifestations of tropical diseases and aims to create awareness among the caregivers. Key Points • It is crucial to be aware and identify infectious diseases presenting with rheumatic manifestations in the tropics. • Presentations akin to classic rheumatic syndromes such as rheumatoid arthritis, spondyloarthritis, systemic lupus erythematosus and vasculitis are common.
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Affiliation(s)
- Rasmi Ranjan Sahoo
- Clinical Immunology and Rheumatology Services, Apollomedics Super Specialty Hospitals, Lucknow, 226012, India
| | - Anupam Wakhlu
- Clinical Immunology and Rheumatology Services, Apollomedics Super Specialty Hospitals, Lucknow, 226012, India
| | - Vikas Agarwal
- Department of Clinical Immunology and Rheumatology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow-226014, India.
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Priora M, Borrelli R, Parisi S, Ditto MC, Realmuto C, Laganà A, Centanaro Di Vittorio C, Degiovanni R, Peroni CL, Fusaro E. Autoantibodies and Rheumatologic Manifestations in Hepatitis C Virus Infection. BIOLOGY 2021; 10:1071. [PMID: 34827064 PMCID: PMC8614641 DOI: 10.3390/biology10111071] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 10/17/2021] [Accepted: 10/18/2021] [Indexed: 12/11/2022]
Abstract
HCV is a virus that can cause chronic infection which can result in a systemic disease that may include many rheumatologic manifestations such as arthritis, myalgia, sicca syndrome, cryoglobulinemia vasculitis as well as other non-rheumatological disorders (renal failure, onco-haematological malignancies). In this population, the high frequency of rheumatoid factor (45-70%), antinuclear (10-40%) and anticardiolipin (15-20%) antibodies is a B-cell mediated finding sustained by the infection. However, the possibility that a primitive rheumatic pathology may coexist with the HCV infection is not to be excluded thus complicating a differential diagnosis between primitive and HCV-related disorders.
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Affiliation(s)
- Marta Priora
- Department of General and Specialistic Medicine, Rheumatology Clinic, Hospital of Mondovì, 12084 Cuneo, Italy
| | - Richard Borrelli
- Rheumatology Unit, Department of General and Specialistic Medicine, Azienda Ospedaliero Universitaria Città Della Salute e Della Scienza di Torino, 10126 Turin, Italy; (R.B.); (S.P.); (M.C.D.); (C.R.); (A.L.); (C.C.D.V.); (R.D.); (C.L.P.); (E.F.)
| | - Simone Parisi
- Rheumatology Unit, Department of General and Specialistic Medicine, Azienda Ospedaliero Universitaria Città Della Salute e Della Scienza di Torino, 10126 Turin, Italy; (R.B.); (S.P.); (M.C.D.); (C.R.); (A.L.); (C.C.D.V.); (R.D.); (C.L.P.); (E.F.)
| | - Maria Chiara Ditto
- Rheumatology Unit, Department of General and Specialistic Medicine, Azienda Ospedaliero Universitaria Città Della Salute e Della Scienza di Torino, 10126 Turin, Italy; (R.B.); (S.P.); (M.C.D.); (C.R.); (A.L.); (C.C.D.V.); (R.D.); (C.L.P.); (E.F.)
| | - Cristina Realmuto
- Rheumatology Unit, Department of General and Specialistic Medicine, Azienda Ospedaliero Universitaria Città Della Salute e Della Scienza di Torino, 10126 Turin, Italy; (R.B.); (S.P.); (M.C.D.); (C.R.); (A.L.); (C.C.D.V.); (R.D.); (C.L.P.); (E.F.)
| | - Angela Laganà
- Rheumatology Unit, Department of General and Specialistic Medicine, Azienda Ospedaliero Universitaria Città Della Salute e Della Scienza di Torino, 10126 Turin, Italy; (R.B.); (S.P.); (M.C.D.); (C.R.); (A.L.); (C.C.D.V.); (R.D.); (C.L.P.); (E.F.)
| | - Chiara Centanaro Di Vittorio
- Rheumatology Unit, Department of General and Specialistic Medicine, Azienda Ospedaliero Universitaria Città Della Salute e Della Scienza di Torino, 10126 Turin, Italy; (R.B.); (S.P.); (M.C.D.); (C.R.); (A.L.); (C.C.D.V.); (R.D.); (C.L.P.); (E.F.)
| | - Rosanna Degiovanni
- Rheumatology Unit, Department of General and Specialistic Medicine, Azienda Ospedaliero Universitaria Città Della Salute e Della Scienza di Torino, 10126 Turin, Italy; (R.B.); (S.P.); (M.C.D.); (C.R.); (A.L.); (C.C.D.V.); (R.D.); (C.L.P.); (E.F.)
| | - Clara Lisa Peroni
- Rheumatology Unit, Department of General and Specialistic Medicine, Azienda Ospedaliero Universitaria Città Della Salute e Della Scienza di Torino, 10126 Turin, Italy; (R.B.); (S.P.); (M.C.D.); (C.R.); (A.L.); (C.C.D.V.); (R.D.); (C.L.P.); (E.F.)
| | - Enrico Fusaro
- Rheumatology Unit, Department of General and Specialistic Medicine, Azienda Ospedaliero Universitaria Città Della Salute e Della Scienza di Torino, 10126 Turin, Italy; (R.B.); (S.P.); (M.C.D.); (C.R.); (A.L.); (C.C.D.V.); (R.D.); (C.L.P.); (E.F.)
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Chung SW. Vasculitis: From Target Molecules to Novel Therapeutic Approaches. Biomedicines 2021; 9:757. [PMID: 34209028 PMCID: PMC8301353 DOI: 10.3390/biomedicines9070757] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 06/17/2021] [Accepted: 06/25/2021] [Indexed: 12/18/2022] Open
Abstract
Systemic vasculitis is a group of diverse diseases characterized by immune-mediated inflammation of blood vessels. Current treatments for vasculitis, such as glucocorticoids and alkylating agents, are associated with significant side effects. In addition, the management of both small and large vessel vasculitis is challenging due to a lack of robust markers of disease activity. Recent research has advanced our understanding of the pathogenesis of both small and large vessel vasculitis, and this has led to the development of novel biologic therapies capable of targeting key cytokine and cellular effectors of the inflammatory cascade. It is anticipated that these novel treatments will lead to more effective and less toxic treatment regimens for patients with systemic vasculitis.
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Affiliation(s)
- Sang-Wan Chung
- Division of Rheumatology, Department of Internal Medicine, School of Medicine, Kyung Hee University, 26 Kyungheedae-ro, Dongdaemun-gu, Seoul 02447, Korea
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