View More View Less
  • 1 Department of Medical Sciences and Public Health and Unit of Allergy and Clinical Immunology, University Hospital “Duilio Casula”, University of Cagliari, Monserrato (Cagliari), , Italy
Restricted access

Purchase article

USD  $25.00

1 year subscription (Individual Only)

USD  $784.00

Systemic lupus erythematosus (SLE) is a multisystemic autoimmune disease that can affect major organs possibly leading to life-threatening complications and appears with heterogeneous clinical picture. SLE could present with broad spectrum of clinical and laboratory features that can resemble those of other diseases, such as hemopoietic malignancies, infections, or immune-mediated disorders. Its complexity and protean features overlap with many other diseases, hindering the differential diagnosis. Rarely, true overlap with other diseases may occur. Herein, we report a case series of two patients affected by infectious diseases, namely visceral leishmaniasis and Whipple’s disease (WD), intertwined with clinical or serological features of SLE. In both cases, several confounding factors have led to a delay in the diagnosis. Moreover, we first describe the persistent elevation of autoantibodies and a monoclonal gammopathy in a patient with WD. Awareness of unusual presentations of infections or other rare disorders, which may be encountered in clinical practice when taking care of SLE patients, is essential for timely diagnosis and treatment of potentially lethal diseases.

  • 1.

    Rahman, A., Isenberg, D. A.: Systemic lupus erythematosus. N Engl J Med 358, 929939 (2008).

  • 2.

    Tan, E. M., Cohen, A. S., Fries, J. F., Masi, A. T., McShane, D. J., Rothfield, N. F., Schaller, J. G., Talal, N., Winchester, R. J.: The 1982 revised criteria for the classification of systemic lupus erythematosus. Arthritis Rheum 25, 12711277 (1982).

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 3.

    Hochberg, M. C.: Updating the American College of Rheumatology revised criteria for the classification of systemic lupus erythematosus. Arthritis Rheum 40, 1725 (1997).

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 4.

    Bertsias, G., Ioannidis, J. P., Boletis, J., Bombardieri, S., Cervera, R., Dostal, C., Font, J., Gilboe, I. M., Houssiau, F., Huizinga, T.: EULAR recommendations for the management of systemic lupus erythematosus. Report of a Task Force of the EULAR Standing Committee for International Clinical Studies Including Therapeutics. Ann Rheum Dis 67, 195205 (2008).

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 5.

    Jansen, A. F. M., Raijmakers, R. P. H., Keijmel, S. P., van der Molen, R. G., Vervoort, G. M., van der Meer, J. W. M., van Deuren, M., Bleeker-Rovers, C. P.: Autoimmunity and B-cell dyscrasia in acute and chronic Q fever: A review of the literature. Eur J Intern Med 54, 612 (2018).

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 6.

    Murgia, G., Firinu, D., Meleddu, R., Lorrai, M. M., Manconi, P. E., Del Giacco, S. R.: Systemic lupus erythematosus occurring in a patient with Niemann-Pick type B disease. Lupus 24, 13321334 (2015).

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 7.

    Gras, E., Matias-Guiu, X., Garcia, A., Argüelles, R., Espinosa, I., Sancho, F. J., Sola, R., Martinez-Araque, M. J., Conde, J., Teruel, A., Prat, J.: PCR analysis in the pathological diagnosis of Whipple’s disease: Emphasis on extraintestinal involvement or atypical morphological features. J Pathol 188, 318321 (1999).

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 8.

    Steri, M., Orrù, V., Idda, M. L., Pitzalis, M., Pala, M., Zara, I., Sidore, C., Faà, V., Floris, M., Deiana, M.: Overexpression of the cytokine BAFF and autoimmunity risk. N Engl J Med 376, 16151626 (2017).

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 9.

    Cooper, G. S., Dooley, M. A., Treadwell, E. L., St Clair, E. W., Gilkeson, G. S.: Risk factors for development of systemic lupus erythematosus: Allergies, infections, and family history. J Clin Epidemiol 55, 982989 (2002).

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 10.

    Rigante, D., Mazzoni, M. B., Esposito, S.: The cryptic interplay between systemic lupus erythematosus and infections. Autoimmun Rev 13, 96102 (2014).

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 11.

    Samarkos, M., Vaiopoulos, G.: The role of infections in the pathogenesis of autoimmune diseases. Curr Drug Targets Inflamm Allergy 4, 99103 (2005).

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 12.

    Draborg, A. H., Duus, K., Houen, G.: Epstein-Barr virus in systemic autoimmune diseases. Clin Dev Immunol 2013, 535738 (2013).

  • 13.

    Pavlovic, M., Kats, A., Cavallo, M., Shoenfeld, Y.: Clinical and molecular evidence for association of SLE with parvovirus B19. Lupus 19, 783792 (2010).

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 14.

    Quaresma, J. A., Yoshikawa, G. T., Koyama, R. V., Dias, G. A., Fujihara, S., Fuzii, H. T.: HTLV-1, immune response and autoimmunity. Viruses 8, 5 (2015)

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 15.

    Hayashi, T., Lee, S., Ogasawara, H., Sekigawa, I., Iida, N., Tomino, Y., Hashimoto, H., Hirose, S.: Exacerbation of systemic lupus erythematosus related to cytomegalovirus infection. Lupus 7, 561564 (1998).

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 16.

    Nawata, M., Seta, N., Yamada, M., Sekigawa, I., Lida, N., Hashimoto, H.: Possible triggering effect of cytomegalovirus infection on systemic lupus erythematosus. Scand J Rheumatol 30, 360362 (2001).

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 17.

    Putterman, C., Caricchio, R., Davidson, A., Perlman, H.: Systemic lupus erythematosus. Clin Dev Immunol 2012, 437282 (2012).

  • 18.

    Kyle, R. A., Therneau, T. M., Rajkumar, S. V., Larson, D. R., Plevak, M. F., Offord, J. R., Dispenzieri, A., Katzmann, J. A., Melton, L. J.: Prevalence of monoclonal gammopathy of undetermined significance. N Engl J Med 354, 13621369 (2006).

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 19.

    van Griensven, J., Diro, E.: Visceral leishmaniasis. Infect Dis Clin North Am 26, 309322 (2012).

  • 20.

    Verma, N., Lal, C. S., Rabidas, V., Pandey, K., Singh, D., Kumar, S., Verma, R. B., Das, P.: Microalbuminuria and glomerular filtration rate in paediatric visceral leishmaniasis. Biomed Res Int 2013, 498918 (2013).

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 21.

    Bogdan, C.: Leishmaniasis in rheumatology, haematology and oncology: Epidemiological, immunological and clinical aspects and caveats. Ann Rheum Dis 71, i6066 (2012).

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 22.

    Voulgarelis, M., Voulgari, P. V., Serelis, J., Drosos, A. A., Skopouli, F. N.: Visceral leishmaniasis resembling systemic lupus erythematosus. Clin Rheumatol 22, 452455 (2003).

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 23.

    Sakkas, L. I., Boulbou, M., Kyriakou, D., Makri, I., Sinani, C., Germenis, A., Stathakis, N.: Immunological features of visceral leishmaniasis may mimic systemic lupus erythematosus. Clin Biochem 41, 6568 (2008).

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 24.

    Sinha, P. K., van Griensven, J., Pandey, K., Kumar, N., Verma, N., Mahajan, R., Kumar, P., Kumar, R., Das, P., Mitra, G.: Liposomal amphotericin B for visceral leishmaniasis in human immunodeficiency virus-coinfected patients: 2-year treatment outcomes in Bihar, India. Clin Infect Dis 53, e91e98 (2011).

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 25.

    Rombola, F., Spinoso, A., Bertuccio, S. N.: Monoclonal gammopathy after visceral leishmaniasis: Just a coincidence? Infez Med 16, 173174 (2008).

    • Search Google Scholar
    • Export Citation
  • 26.

    Schneider, T., Moos, V., Loddenkemper, C., Marth, T., Fenollar, F., Raoult, D.: Whipple’s disease: New aspects of pathogenesis and treatment. Lancet Infect Dis 8, 179190 (2008).

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 27.

    Bruhlmann, P., Michel, B.A., Altwegg, M.: Diagnosis and therapy monitoring of Whipple’s arthritis by polymerase chain reaction. Rheumatology 39, 14271428 (2000).

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 28.

    Appak, Ö., Türkel, S., Esen, N., Özkütük, A.A.: Comparison of polymerase chain reaction-restriction enzyme analysis method and DNA sequence analysis results in the identification of non-tuberculous mycobacteria. Acta Microbiol Immunol Hung 65, 515527 (2018).

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 29.

    Ehrenfeld, M., Urowitz, M. B., Platts, M. E.: Selective C4 deficiency, systemic lupus erythematosus, and Whipple’s disease. Ann Rheum Dis 43, 9194 (1984).

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 30.

    Arnold, C. A., Moreira, R. K., Lam-Himlin, D., De Petris, G., Montgomery, E.: Whipple disease a century after the initial description: Increased recognition of unusual presentations, autoimmune comorbidities, and therapy effects. Am J Surg Pathol 36, 10661073 (2012).

    • Crossref
    • Search Google Scholar
    • Export Citation

 

The author instruction is available in PDF.
Please, download the file from HERE

Senior editors

Editor-in-Chief: Prof. Dóra Szabó (Institute of Medical Microbiology, Semmelweis University, Budapest, Hungary)

Managing Editor: Dr. Béla Kocsis (Institute of Medical Microbiology, Semmelweis University, Budapest, Hungary)

Co-editor: Dr. Andrea Horváth (Institute of Medical Microbiology, Semmelweis University, Budapest, Hungary)

Editorial Board

  • Prof. Éva ÁDÁM (Institute of Medical Microbiology, Semmelweis University, Budapest, Hungary)
  • Prof. Sebastian AMYES (Department of Medical Microbiology, University of Edinburgh, Edinburgh, UK.)
  • Dr. Katalin BURIÁN (Institute of Clinical Microbiology University of Szeged, Szeged, Hungary; Department of Medical Microbiology and Immunobiology, University of Szeged, Szeged, Hungary.)
  • Dr. Orsolya DOBAY (Institute of Medical Microbiology, Semmelweis University, Budapest, Hungary)
  • Prof. Ildikó Rita DUNAY (Institute of Inflammation and Neurodegeneration, Medical Faculty, Otto-von-Guericke University, Magdeburg, Germany; Center for Behavioral Brain Sciences (CBBS), Magdeburg, Germany)
  • Prof. Levente EMŐDY(Department of Medical Microbiology and Immunology, University of Pécs, Pécs, Hungary.)
  • Prof. Anna ERDEI (Department of Immunology, Eötvös Loránd University, Budapest, Hungary, MTA-ELTE Immunology Research Group, Eötvös Loránd University, Budapest, Hungary.)
  • Prof. Éva Mária FENYŐ (Division of Medical Microbiology, University of Lund, Lund, Sweden)
  • Prof. László FODOR (Department of Microbiology and Infectious Diseases, University of Veterinary Medicine, Budapest, Hungary)
  • Prof. József KÓNYA (Department of Medical Microbiology, University of Debrecen, Debrecen, Hungary)
  • Prof. Yvette MÁNDI (Department of Medical Microbiology and Immunobiology, University of Szeged, Szeged, Hungary)
  • Prof. Károly MÁRIALIGETI (Department of Microbiology, Eötvös Loránd University, Budapest, Hungary)
  • Prof. János MINÁROVITS (Department of Oral Biology and Experimental Dental Research, University of Szeged, Szeged, Hungary)
  • Prof. Béla NAGY (Centre for Agricultural Research, Institute for Veterinary Medical Research, Budapest, Hungary.)
  • Prof. István NÁSZ (Institute of Medical Microbiology, Semmelweis University, Budapest, Hungary)
  • Prof. Kristóf NÉKÁM (Hospital of the Hospitaller Brothers in Buda, Budapest, Hungary.)
  • Dr. Eszter OSTORHÁZI (Institute of Medical Microbiology, Semmelweis University, Budapest, Hungary)
  • Prof. Rozália PUSZTAI (Department of Medical Microbiology and Immunobiology, University of Szeged, Szeged, Hungary)
  • Prof. Peter L. RÁDY (Department of Dermatology, University of Texas, Houston, Texas, USA)
  • Prof. Éva RAJNAVÖLGYI (Department of Immunology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary)
  • Prof. Ferenc ROZGONYI (Institute of Laboratory Medicine, Semmelweis University, Budapest, Hungary)
  • Prof. Zsuzsanna SCHAFF (2nd Department of Pathology, Semmelweis University, Budapest, Hungary)
  • Prof. Joseph G. SINKOVICS (The Cancer Institute, St. Joseph’s Hospital, Tampa, Florida, USA)
  • Prof. Júlia SZEKERES (Department of Medical Biology, University of Pécs, Pécs, Hungary.)
  • Prof. Mária TAKÁCS (National Reference Laboratory for Viral Zoonoses, National Public Health Center, Budapest, Hungary.)
  • Prof. Edit URBÁN (Department of Medical Microbiology and Immunology University of Pécs, Pécs, Hungary; Institute of Translational Medicine, University of Pécs, Pécs, Hungary.)

 

Editorial Office:
Akadémiai Kiadó Zrt.
Budafoki út 187-187, A/3, H-1117 Budapest, Hungary

Editorial Correspondence:
Acta Microbiologica et Immunologica Hungarica
Institute of Medical Microbiology
Semmelweis University
P.O. Box 370
H-1445 Budapest, Hungary
Phone: + 36 1 459 1500 ext. 56101
Fax: (36 1) 210 2959
E-mail: amih@med.semmelweis-univ.hu

 Indexing and Abstracting Services:

  • Biological Abstracts
  • BIOSIS Previews
  • CAB Abstracts
  • Chemical Abstracts
  • Global Health
  • Index Medicus
  • Index Veterinarius
  • Medline
  • Referativnyi Zhurnal
  • SCOPUS
  • Science Citation Index Expanded
2020  
Total Cites 662
WoS
Journal
Impact Factor
2,048
Rank by Immunology 145/162(Q4)
Impact Factor Microbiology 118/137 (Q4)
Impact Factor 1,904
without
Journal Self Cites
5 Year 0,671
Impact Factor
Journal  0,38
Citation Indicator  
Rank by Journal  Immunology 146/174 (Q4)
Citation Indicator  Microbiology 120/142 (Q4)
Citable 42
Items
Total 40
Articles
Total 2
Reviews
Scimago 28
H-index
Scimago 0,439
Journal Rank
Scimago Immunology and Microbiology (miscellaneous) Q4
Quartile Score Medicine (miscellaneous) Q3
Scopus 438/167=2,6
Scite Score  
Scopus General Immunology and Microbiology 31/45 (Q3)
Scite Score Rank  
Scopus 0,760
SNIP
Days from  225
submission
to acceptance
Days from  118
acceptance
to publication
Acceptance 19%
Rate

2019  
Total Cites
WoS
485
Impact Factor 1,086
Impact Factor
without
Journal Self Cites
0,864
5 Year
Impact Factor
1,233
Immediacy
Index
0,286
Citable
Items
42
Total
Articles
40
Total
Reviews
2
Cited
Half-Life
5,8
Citing
Half-Life
7,7
Eigenfactor
Score
0,00059
Article Influence
Score
0,246
% Articles
in
Citable Items
95,24
Normalized
Eigenfactor
0,07317
Average
IF
Percentile
7,690
Scimago
H-index
27
Scimago
Journal Rank
0,352
Scopus
Scite Score
320/161=2
Scopus
Scite Score Rank
General Immunology and Microbiology 35/45 (Q4)
Scopus
SNIP
0,492
Acceptance
Rate
16%

 

Acta Microbiologica et Immunologica Hungarica
Publication Model Online only Hybrid
Submission Fee none
Article Processing Charge 1100 EUR/article
Regional discounts on country of the funding agency World Bank Lower-middle-income economies: 50%
World Bank Low-income economies: 100%
Further Discounts Editorial Board / Advisory Board members: 50%
Corresponding authors, affiliated to an EISZ member institution subscribing to the journal package of Akadémiai Kiadó: 100%
Subscription fee 2022 Online subsscription: 662 EUR / 832 USD
Print + online subscription: 740 EUR / 930 USD
Subscription Information Online subscribers are entitled access to all back issues published by Akadémiai Kiadó for each title for the duration of the subscription, as well as Online First content for the subscribed content.
Purchase per Title Individual articles are sold on the displayed price.

Acta Microbiologica et Immunologica Hungarica
Language English
Size A4
Year of
Foundation
1954
Volumes
per Year
1
Issues
per Year
4
Founder Magyar Tudományos Akadémia
Founder's
Address
H-1051 Budapest, Hungary, Széchenyi István tér 9.
Publisher Akadémiai Kiadó
Publisher's
Address
H-1117 Budapest, Hungary 1516 Budapest, PO Box 245.
Responsible
Publisher
Chief Executive Officer, Akadémiai Kiadó
ISSN 1217-8950 (Print)
ISSN 1588-2640 (Online)

Monthly Content Usage

Abstract Views Full Text Views PDF Downloads
Aug 2021 9 0 0
Sep 2021 9 0 0
Oct 2021 12 0 0
Nov 2021 6 0 0
Dec 2021 13 0 0
Jan 2022 28 2 1
Feb 2022 0 0 0