%0 Journal Article
%9 ACL : Articles dans des revues avec comité de lecture répertoriées par l'AERES
%A Million, M.
%A Thuny, F.
%A Bardin, N.
%A Angelakis, E.
%A Edouard, S.
%A Bessis, S.
%A Guimard, T.
%A Weitten, T.
%A Martin-Barbaz, F.
%A Texereau, M.
%A Ayouz, K.
%A Protopopescu, C.
%A Carrieri, P.
%A Habib, G.
%A Raoult, Didier
%T Antiphospholipid antibody syndrome with valvular vegetations in acute Q fever
%D 2016
%L PAR00014427
%G ENG
%J Clinical Infectious Diseases
%@ 1058-4838
%K Q fever ; Coxiella burnetii ; antiphospholipid antibodies ; valvular heart ; disease
%K FRANCE
%M ISI:000371715600007
%N 5
%P 537-544
%R 10.1093/cid/civ956
%U https://www.documentation.ird.fr/hor/PAR00014427
%V 62
%W Horizon (IRD)
%X Background. Coxiella burnetii endocarditis is considered to be a late complication of Q fever in patients with preexisting valvular heart disease (VHD). We observed a large transient aortic vegetation in a patient with acute Q fever and high levels of IgG anticardiolipin antibodies (IgG aCL). Therefore, we sought to determine how commonly acute Q fever could cause valvular vegetations associated with antiphospholipid antibody syndrome, which would be a new clinical entity. Methods. We performed a consecutive case series between January 2007 and April 2014 at the French National Referral Center for Q fever. Age, sex, history of VHD, immunosuppression, and IgG aCL assessed by enzyme-linked immunosorbent assay were tested as potential predictors. Results. Of the 759 patients with acute Q fever and available echocardiographic results, 9 (1.2%) were considered to have acute Q fever endocarditis, none of whom had a previously known VHD. After multiple adjustment, very high IgG aCL levels (>100 immunoglobulin G-type phospholipid units; relative risk [RR], 24.9 [95% confidence interval {CI}, 4.5-140.2]; P = .002) and immunosuppression (RR, 10.1 [95% CI, 3.0-32.4]; P = .002) were independently associated with acute Q fever endocarditis. Conclusions. Antiphospholipid antibody syndrome with valvular vegetations in acute Q fever is a new clinical entity. This would suggest the value of systematically testing for C. burnetii in antiphospholipid-associated cardiac valve disease, and performing early echocardiography and antiphospholipid dosages in patients with acute Q fever.
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