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芭托尼拉菌与内心炎相关的淋巴细胞炎:一种模仿自身免疫和血管炎的模仿剂

Nicole K Andeen¹, Vanderlene L Kung¹, Jane K Nguyen²

¹Department of Pathology and Laboratory Medicine, Oregon Health and Science University, Portland, Oregon, USA.

Kidney international reports

|April 30, 2025

概括

巴托内拉感染性内心炎 (IE) 可以导致模仿自身免疫性疾病的血球炎 (GN),往往会延迟诊断. 早期识别巴托内拉IEGN对于适当的治疗和脏结果至关重要.

科学领域:

腎臟病學 (nephrology) 是一種醫學專業.
传染性疾病传染性疾病
心脏病学心脏病学

背景情况:

巴尔托内拉菌种是导致培养负性传染性内心炎 (IE) 的细菌.
感染性脑膜炎可能导致与感染相关的脑膜膜炎 (IRGN),呈现独特的临床和病理特征.
区分巴托内拉相关的IEGN与自身免疫性淋巴结膜炎是具有挑战性的,因为呈现重叠.

研究的目的:

描述由巴顿氏菌传染性内心炎 (IEGN) 引起的质炎 (GN) 的临床,病理和结局特征.
为了比较巴托尼拉IEGN与培养阳性IEGN和非内心炎IRGN.
在IEGN中识别与病进展相关的因素.

主要方法:

从三家机构对20例巴顿氏菌IEGN病例进行了回顾性分析.
与49例培养阳性IEGN病例和30例非内心炎IRGN病例进行比较.
对临床数据,活检结果和患者结局的审查.

主要成果:

巴托内拉IEGN发生在8-21%的IEGN病例中,通常与先前存在的心脏膜疾病,ANCA阳性,低补血和血液异常有关.
巴托内拉内心炎的诊断经常被推迟到脏活检后.
在病理上,巴托内拉IEGN显示焦点半月形GN与共主C3和强的IgM/C1q沉积或pauci-immune模式.
进展到末期病 (ESKD) 与较高的肌素,性综合征,女性性别和C1q强度有关.

结论:

巴托内拉IEGN表现出独特的特征,可以模仿自身免疫性GN,可能导致诊断延迟.
尽管诊断延迟和先前的免疫抑制,巴托内拉IEGN的结果并不显著地比培养阳性IEGN更糟.
识别巴托内拉IEGN对于适当的管理和防止误诊作为自身免疫性疾病至关重要.

关键词:

巴尔托内拉巴尔托内拉科西埃拉 (Coxiella) 是一种状的植物.在IRGN的基础上.心内膜炎是一种心内膜炎.与感染相关的 GN GN.血管炎是一种血管炎.

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