Article
Characterization of ferritin peptide autoantibody positive patients with infectious febrile diseases
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Published: | September 1, 2015 |
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Introduction: Giant cell arteritis (GCA) affecting medium and large arteries and polymyalgia rheumatica (PMR) causing muscle ache and stiffness are both frequent rheumatic disorders in the elderly population. Our group described the association of ferritin autoantibodies (AFA) with early untreated GCA/PMR. However, we observed in our daily routine that patients with severe infectious diseases (ID) were frequently positive as well. We evaluated ID patients for the presence of AFA.
Methods: Sera of patients with ID (primarily febrile HIV+ patients (n=50), patients with chronic hepatitis (n=51) and patients with sepsis or severe pneumonia (n=14)), sera of patients with GCA/PMR (n=30) and of blood donors (n=45) were analyzed. GCA/PMR patients were with (n=11) or without treatment (n=6), had active disease (n=21) or were in partial remission (n=3). All samples were collected at Hannover Medical School and tested on an established ELISA using anti-human IgG Fc as secondary antibody. SPSS and GraphPad Prism 5 software were used for statistical analysis.
Results: In our cohort 73% of patients with ID had a positive result, while 67% of untreated GCA/PMR patients and 7% of healthy blood donors were positive for AFA. In the subgroup analysis of ID patients we found that 78% of HIV patients, 74% of hepatitis patients and 65% of patients with either sepsis or severe pneumonia had antibodies directed against ferritin.
Conclusion: We conclude that hospitalized patients with severe ID (both viral and bacterial) are often positive for AFA. Severe infections have to be taken into account in the interpretation of a positive AFA.