RESUMEN
Background: Previous history of COVID-19 infection is a natural booster of the vaccine response in the general population. The response to COVID-19 vaccines is lessened in Inflammatory Bowel Disease patients on selected class of immunosuppressive treatments. Aims: The study was to assess anti-SARS-CoV-2 spike-specific IgG antibody response in Inflammatory Bowel Disease patients with a history of COVID-19 infection. Patients and methods: This single-center prospective study involved 504 Inflammatory Bowel Disease patients. Demographic data and clinical data were gathered through questionnaires and patient charts. Anti-SARS-CoV-2 spike-specific and antinucleocapsid antibody levels were measured at T1, T2 (after the 2-dose series), and T3 or T4 (booster vaccine). Results: This study included 504 Inflammatory Bowel Disease patients, and 234 completed one year follow-up with blood tests. Positive anti-nucleocapsid serology or history of COVID-19 infection was significantly associated with increased median anti- SARS-CoV-2 spike-specific IgG titers after the 2-dose series (1930 BAU/mL vs. 521 BAU/mL p < 0.0001) and the booster vaccine (4390 BAU/mL vs. 2160 BAU/mL, p = 0.0156). Multivariate analysis showed that higher anti-SARS-CoV-2 spike-specific IgG levels were independently associated with anti-nucleocapsid antibodies at T2 (OR=2.23, p < 0.0001) and T3 (OR=1.72, p = 0.00011). Immunosuppressive treatments did not impact the antibody response or levels in patients with a history of COVID-19 infection or positive anti-nucleocapsid serology. Conclusions: In Inflammatory Bowel Disease, prior COVID-19 infection or positive anti-nucleocapsid serology leads to increased anti-SARS-CoV-2 spike-specific IgG levels after vaccination, regardless of immunosuppressive treatments. This emphasizes the significance of accounting for previous infection in vaccination approaches.
Asunto(s)
Anticuerpos Antivirales , Vacunas contra la COVID-19 , COVID-19 , Inmunoglobulina G , Enfermedades Inflamatorias del Intestino , SARS-CoV-2 , Humanos , COVID-19/inmunología , COVID-19/prevención & control , Femenino , Masculino , Enfermedades Inflamatorias del Intestino/inmunología , Enfermedades Inflamatorias del Intestino/tratamiento farmacológico , Vacunas contra la COVID-19/inmunología , Anticuerpos Antivirales/sangre , Anticuerpos Antivirales/inmunología , Persona de Mediana Edad , SARS-CoV-2/inmunología , Adulto , Estudios Prospectivos , Inmunoglobulina G/sangre , Inmunoglobulina G/inmunología , Anciano , Inmunización Secundaria , Glicoproteína de la Espiga del Coronavirus/inmunologíaRESUMEN
Tuberous sclerosis is an autosomal dominant genetic disorder that is characterized by epilepsy, mental retardation and facial angiofibromas. Usually, the disease is diagnosed in childhood but there are frustrates form of tuberous sclerosis with or without genetic mutation. This clinical case about a man who is diagnosed a colonic polyposis, a rectal adenocarcinoma and a tuberous sclerosis.
La sclérose tubéreuse de Bourneville (STB) est une maladie génétique autosomique dominante qui se manifeste principalement par la triade épilepsie, retard mental et angiofibromes faciaux. Généralement, elle est diagnostiquée dans l'enfance, mais il existe des formes cliniques frustres avec ou sans mutations génétiques. La recherche d'autres manifestations cliniques peut aider au diagnostic notamment l'atteinte intestinale. Notre cas clinique rapporte la découverte d'une polypose intestinale et d'un cancer du rectum chez un patient méconnu de sa maladie génétique. L'intérêt est de voir, à partir de la littérature, la fréquence de la polypose colique ainsi que du cancer colorectal dans la STB et de se poser la question d'un dépistage systématique dans cette population.