Serological interpretation of rheumatic manifestations in brucellosis

Abstract

Objectives: To investigate the profile of autoimmune markers and to evaluate the status of vitamin D in the autoimmune process in brucellosis. Study Design: Descriptive study. Place and Duration of Study: Department of Rheumatology and Microbiology-Basic Immunology, Balikesir Ataturk City Hospital, Turkey, between June 2017 and December 2020. Methodology: Brucella seropositive patients (mean age 46.58 +/- 15.43 years, 43.7% females) were investigated retrospectively in terms of clinical manifestations, rheumatoid factor (RF), anti-cyclic citrullinated peptide (anti-CCP), antinuclear antibody (ANA), and vitamin D (25OHD) levels. Patients were grouped as low Brucella (<1/160), high Brucella (>= 1/160) titers, and the control group consisted of Brucella negative patients. Clinical manifestations, RF, anti-CCP, ANA, and 25 OHD levels were compared among the three groups. Correlation analysis was performed between autoimmune markers and 25OHD levels. Results: The most common symptom among all Brucella seropositive patients was polyarthralgia (57.7%). RF positivity was found higher in two patient-groups than the control group (p = 0.008). Anti-CCP positivity was found higher in patient-groups than the control group (p <0.001). ANA levels were similar among the three groups (p = 0.077). Median 25OHD levels were found significantly lower in patient-groups than the control group (p <0.001). No correlation was found among vitamin D, RF, anti-CCP, and ANA levels (p = 0.501, p = 0.613 and p = 0.616, respectively). Conclusions: Increased rates of RF, anti-CCP; and decreased 25OHD levels in Brucella seropositive patients. It is important to consider brucellosis in the differential diagnosis of patients with rheumatologic manifestations in the presence of autoimmune markers.