Subject(s)
Atrial Fibrillation , COVID-19 , Stroke , Atrial Fibrillation/diagnosis , Hospital Mortality , Humans , Risk FactorsABSTRACT
An adjuvant is an immunological or pharmacological substance or group of substances that can be added to a given agent to enhance its effect in terms of efficacy, effectiveness and potency. Different mechanisms have been hypothesized underlying the action of the adjuvant, including boosting immune (innate and adaptive) response: this generally results in sparing the necessary amount of the agent and can potentially reduce the frequency of the needed number of therapeutic interventions. Adjuvants can be commonly found in vaccines, immunization products, mineral oils, cosmetics, silicone breast implants and other therapeutic/medical devices, being usually safe and effective. However, in a fraction of genetically susceptible and predisposed subjects, the administration of adjuvants may lead to the insurgence of serious side-effects, called "autoimmune/inflammatory syndrome by adjuvants" (ASIA) or Shoenfeld's syndrome. The present review is aimed at focusing on the "endocrine pebbles" of the mosaic of autoimmunity and of the ASIA syndrome, collecting together 54 cases of sub-acute thyroiditis, 2 cases of Hashimoto's thyroiditis, 11 cases of primary ovarian failure/primary ovarian insufficiency, 13 cases of autoimmune diabetes type 1, and 1 case of autoimmune adrenal gland insufficiency occurred after exposure to adjuvants.
Subject(s)
Adjuvants, Immunologic/adverse effects , Autoimmune Diseases/chemically induced , Autoimmunity/drug effects , Endocrine System Diseases/chemically induced , Autoimmune Diseases/genetics , Autoimmunity/genetics , Diabetes Mellitus, Type 1/chemically induced , Diabetes Mellitus, Type 1/genetics , Diabetes Mellitus, Type 1/immunology , Drug-Related Side Effects and Adverse Reactions/genetics , Drug-Related Side Effects and Adverse Reactions/immunology , Endocrine System Diseases/genetics , Endocrine System Diseases/immunology , Genetic Predisposition to Disease , Humans , Risk Factors , SyndromeABSTRACT
BACKGROUND AND OBJECTIVES: Rheumatoid arthritis (RA) is the most common inflammatory joint disorder presenting also with extra-articular manifestations. As many other autoimmune diseases, it has been suggested that infectious diseases might contribute to its emergence. Hepatitis viruses were suggested by several reports as a trigger of RA onset. We aimed to assess the association between RA and chronic hepatitis B viral infection (HBV). METHODS: Patients with RA were compared with age- and sex-matched controls regarding the proportion of chronic HBV infection in a case-control study. The chi-square and t tests were used for univariate analysis, whereas a logistic regression model was used for multivariate analysis. The study was performed utilizing the medical database of Clalit Health Services. RESULTS: There was a significantly higher proportion of chronic HBV infection in RA patients compared with controls (1.19% vs 0.63%, respectively; p < 0.001). In a multivariate logistic regression analysis, RA was significantly associated with chronic HBV infection (OR = 1.89, 95%CI 1.55-2.29, p < 0.001). CONCLUSIONS: Patients with RA have a greater proportion of chronic HBV infection than matched controls. Screening for HBV infection among RA patients may be warranted.
Subject(s)
Arthritis, Rheumatoid/complications , Hepatitis B, Chronic/epidemiology , Adult , Aged , Case-Control Studies , Cross-Sectional Studies , Databases, Factual , Female , Humans , Israel/epidemiology , Logistic Models , Male , Middle Aged , Multivariate AnalysisABSTRACT
The association between viral infection and autoimmune diseases is an established phenomenon in medicine. Hepatitis C viral infection is known to have such an association; however, its association with systemic lupus erythematosus has not been studied in a real life study driven from a large national database. The objective of this study was to investigate the association between SLE and chronic hepatitis C viral infection. Patients with SLE were compared with age- and sex-matched controls regarding the proportion chronic HCV infection. Chi-square and t tests were used for univariate analysis, and a logistic regression model was used for multivariate analysis. The study was performed utilizing the medical database of Clalit Health Services in Israel. There was a significant higher proportion of hepatitis C viral infection in SLE patients as compared to controls (1.06 and 0.39%, respectively; p < 0.001). A significant association was also observed among patients of higher socioeconomic status. In a multivariate logistic regression analysis, SLE was significantly associated with hepatitis C viral infection (OR = 2.07, 95% CI = 1.46-2.90). To conclude, Patients with SLE have a greater proportion of chronic HCV infection than matched controls.
