Bartonella henselae: A Possible Cause of Henoch-Schonlein Purpura

Field: Medicine (Health Sciences)

Infectious Diseases| April 01 2002 Bartonella henselae: A Possible Cause of Henoch-Schönlein Purpura AAP Grand Rounds (2002) 7 (4): 45. https://doi.org/10.1542/gr.7-4-45 Views Icon Views Article contents Figures & tables Video Audio Supplementary Data Peer Review Share Icon Share Twitter LinkedIn Tools Icon Tools Get Permissions Cite Icon Cite Search Site Citation Bartonella henselae: A Possible Cause of Henoch-Schönlein Purpura. AAP Grand Rounds April 2002; 7 (4): 45. https://doi.org/10.1542/gr.7-4-45 Download citation file: Ris (Zotero) Reference Manager EasyBib Bookends Mendeley Papers EndNote RefWorks BibTex toolbar search nav search search input Search input auto suggest search filter All PublicationsAll JournalsAAP Grand RoundsPediatricsHospital PediatricsPediatrics In ReviewNeoReviewsAAP NewsAll AAP Sites Search Advanced Search Topics: bartonella henselae, henoch-schoenlein purpura Source: Ayoub EM, McBride J, Schmiederer J, et al. Role of Bartonella henselae in the etiology of Henoch-Schönlein purpura. Pediatr Infect Dis J. 2002;21:28–31. Investigators from Florida tested stored serum samples from 18 patients (2 to 15 years old) diagnosed with Henoch-Schönlein purpura (HSP), all of whom presented with the characteristic rash. Blood samples were taken from within 4 weeks of start of illness to about 4 months after. Control serum samples were obtained from 57 individuals including 31 healthy children or college students and 26 individuals with various illnesses. Patients and controls were from the same geographic region. No attempt was made to document contact with cats. All serum samples were tested for IgG and IgA indirect immunofluorescent antibodies against B henselae and the individuals performing the tests were blinded to the origin of sera (patients or controls). All sera were also tested for streptococcal antibodies (anti-streptolysin O and anti-DNase B). Sera of 10 (56%) of 18 patients and 8 (14%) of 57 controls were IgG positive (≥1:64). Three of 8 cases with negative antibody titers had additional serum samples obtained at follow-up and 2 of these convalescent sera demonstrated a rise in antibody titers (<64 to 512). The logs of the geometric means of IgG antibody titers in patients and controls were significantly different (2.17 vs 1.63, P<.0005). IgA antibody titers were negative (<1:16) in sera of both patients and controls. Elevated streptococcal antibodies were present in 7 (39%) of 18 patients and none of the controls. The etiology of HSP remains elusive. However, epidemiologic studies suggest the possibility of an infectious cause.1 Group A beta-hemolytic streptococci, adenovirus, parvovirus and hepatitis B virus have all been implicated as possible causes; none has been confirmed. In fact, in the same issue of the journal another group reported no association between HSP and parvovirus B19.2 While B henselae is the documented etiologic agent of cat scratch disease,3 the small numbers in the above retrospective study preclude definite conclusions regarding its role in HSP. It is possible that the patients, who were younger than the controls, had a higher incidence of contact with cats resulting in the higher rate of positivity for B henselae antibodies. The experience of these authors needs to be replicated using a larger cohort of prospectively evaluated patients. Until the etiologic relationship between B henselae and HSP is confirmed, treatment of HSP with antibiotics cannot be recommended. You do not currently have access to this content.