%0 Journal Article
%9 ACL : Articles dans des revues avec comité de lecture répertoriées par l'AERES
%A Million, M.
%A Walter, G.
%A Bardin, N.
%A Camoin, L.
%A Giorgi, R.
%A Bongrand, P.
%A Gouriet, F.
%A Casalta, J. P.
%A Thuny, F.
%A Habib, G.
%A Raoult, Didier
%T Immunoglobulin G anticardiolipin antibodies and progression to Q fever endocarditis
%D 2013
%L PAR00010729
%G ENG
%J Clinical Infectious Diseases
%@ 1058-4838
%K Q fever ; Coxiella burnetii ; antiphospholipid ; anticardiolipin ; endocarditis
%M ISI:000320923700010
%N 1
%P 57-64
%R 10.1093/cid/cit191
%U https://www.documentation.ird.fr/hor/PAR00010729
%V 57
%W Horizon (IRD)
%X Background. Immunoglobulin G (IgG) anticardiolipin (aCL) antibodies are associated with valvulopathy and endocarditis in patients with lupus and other diseases. During acute Q fever, high IgG aCL prevalence has been reported, but the clinical significance remains unknown. Methods. To test if increased IgG aCL at acute Q fever diagnosis is associated with an increased risk of progression to endocarditis, all patients diagnosed in the French National Referral Center for Q fever from January 2007 to December 2011 were included and followed regularly until January 2013 in a 5-year prospective cohort study. Q fever endocarditis was defined according to recently updated criteria. Results. Seventy-two patients were followed for a median time of 31 months (interquartile range, 18-47 months). Of these, 13 patients with valvulopathy without antibiotic prophylaxis progressed to endocarditis. IgG aCL levels were highly prevalent (57%) and significantly higher in the presence of a valvulopathy (P =.005). Using Cox regression analysis, highly increased levels of IgG aCL (adjusted hazard ratio [AHR], 12.95; 95% confidence interval, 2.85-58.95; P =.001) and high levels of phase II immunoglobulin M (IgM; AHR, 6.59; 95% CI, 1.37-31.62; P =.018) were the only independent predictors of progression to endocarditis. Conclusions. Rapid progression from acute Q fever to endocarditis is associated with high levels of IgG aCL and high levels of phase II IgM, findings that should be critical in the prevention of endocarditis.
%$ 052 ; 050