RESUMEN
BACKGROUND: Chronic hepatitis C infection is frequently associated with a mixed cryoglobulinaemia and circulating auto-antibodies, especially anti-smooth muscle cells (SMA) and anti-liver/kidney/microsome type 1 (LKM-1) anti-tissue antibodies. Treatments with TNF antagonists favour the emergence of auto-antibodies, and particularly anti-dsDNA antibodies. OBJECTIVE: To determine the impact of TNF antagonists on hepatitis C-related immune abnormalities. METHODS: We prospectively monitored for 14 weeks, six patients with actively replicating chronic hepatitis C, initiating an anti-TNF treatment for an associated rheumatoid arthritis. RESULTS: Anti-nuclear and anti-dsDNA antibodies were induced in two and three patients, respectively. Treatment had no impact on the production of antibodies against extractable nuclear antigens, and it did not induce anti-tissues antibodies in any patient. Cryoglobulinaemia appeared in 2/6 patients, and it persisted in 2 others. No patient developed any news signs of autoimmunity. HCV viraemia remained unchanged. CONCLUSIONS: Induction of auto-antibodies by TNF antagonist treatments does not involve anti-tissues antibodies, even in patients with actively replicating chronic hepatitis C prone to produce anti-SMA and anti-LKM-1 antibodies. In contrast, TNF antagonists may favour emergence of cryoglobulinaemia in such patients.
Asunto(s)
Anticuerpos Monoclonales/uso terapéutico , Autoanticuerpos/sangre , Hepatitis C Crónica/tratamiento farmacológico , Factores de Necrosis Tumoral/inmunología , Adulto , Anticuerpos Antinucleares/sangre , Anticuerpos Monoclonales/efectos adversos , Antirreumáticos/efectos adversos , Antirreumáticos/uso terapéutico , Crioglobulinemia/etiología , Etanercept , Femenino , Hepacivirus/genética , Hepatitis C Crónica/sangre , Hepatitis C Crónica/inmunología , Humanos , Inmunoglobulina G/efectos adversos , Inmunoglobulina G/uso terapéutico , Infliximab , Masculino , Persona de Mediana Edad , Reacción en Cadena de la Polimerasa , Estudios Prospectivos , Receptores del Factor de Necrosis Tumoral/uso terapéutico , Factores de Tiempo , Resultado del Tratamiento , Inhibidores del Factor de Necrosis Tumoral , Carga Viral , Viremia/tratamiento farmacológicoRESUMEN
Leuconostoc spp. is a variety of streptococcus that can cause disease in humans, most notably those with HIV infection or other causes of immunodepression. We report the case of a patient who had Leuconostoc osteomyelitis in an area of lymphedema.
