与疾病发作前的非炎性肌肉骨骼疾病相比，硬皮病患者的感染情况并未增加。

Infections are not increased in scleroderma compared to non-inflammatory musculoskeletal disorders prior to disease onset.

作者信息

Pope Janet E, Goodwin Jodi L, Ouimet Janine M, Krizova Adriana, Laskin Matthew

机构信息

Division of Rheumatology, Department of Medicine, The University of Western Ontario, London, Canada.

出版信息

Open Rheumatol J. 2007;1:12-7. doi: 10.2174/1874312900701010012. Epub 2007 Nov 8.

DOI:10.2174/1874312900701010012

PMID:19088895

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC2581823/

Abstract

UNLABELLED

The etiology of scleroderma (SSc) is unknown; immunogenic stimuli such as infections and vaccinations could theoretically be risk factors for scleroderma. Our objective was to assess the relationship between viral and bacterial infections, and vaccinations, prior to diagnosis of SSc compared to non-inflammatory controls.

METHODS

A questionnaire was sent to individuals with SSc (n =83) and controls (n=351) with non-inflammatory musculoskeletal (MSK) disorders (osteoarthritis, n = 204; tendonitis, n = 58; fibromyalgia, n= 89) from a rheumatology practice. Questions ascertained past infections, exposure to infectious agents and vaccination history.

RESULTS

The response rate was 78% (SSc) and 56% (MSK controls). The mean age was 56 +/- 1.6 (SSc) and 58 +/- 0.9 (MSK); 88% (SSc) and 82% (MSK) were female. No association between prior infections and SSc was observed. In fact, controls were more likely than SSc subjects to report any infection within 1-year prior to disease diagnosis (35% vs. 16%, p<0.006), or to have suffered a trauma to affected joints prior to diagnosis (44% vs. 19%, p<0.0002). Within the 1-year prior to disease diagnosis, controls reported slightly more streptococcal infections (p<0.2), infections with diarrhea and vomiting (p<0.3), and antibiotic use (p<0.09), although none of these results were statistically significant. Histories of any hepatitis, rubella, any bacterial infection, and having had a previous positive tuberculosis skin test were not significantly different between groups and were actually more often reported by the control subjects. SSc reported slightly more hepatitis B (p<0.08), more rheumatic fever (p<0.8) in past, and herpes zoster (p<0.4), although no differences reached significance.

CONCLUSION

This study does not support that self-report of symptomatic infections are more likely to occur ever (prior to diagnosis) or within 1-year prior to symptom onset of SSc, or that vaccinations in adulthood trigger SSc.

摘要

未标注

硬皮病（SSc）的病因尚不清楚；理论上，感染和疫苗接种等免疫原性刺激可能是硬皮病的危险因素。我们的目的是评估与非炎症对照组相比，SSc诊断前病毒和细菌感染及疫苗接种之间的关系。

方法

向来自一家风湿病诊所的SSc患者（n = 83）和患有非炎症性肌肉骨骼（MSK）疾病（骨关节炎，n = 204；肌腱炎，n = 58；纤维肌痛，n = 89）的对照组（n = 351）发送问卷。问题涉及既往感染、接触传染源和疫苗接种史。

结果

回复率为78%（SSc组）和56%（MSK对照组）。平均年龄为56±1.6岁（SSc组）和58±0.9岁（MSK组）；88%（SSc组）和82%（MSK组）为女性。未观察到既往感染与SSc之间存在关联。事实上，对照组比SSc患者更有可能报告在疾病诊断前1年内有任何感染（35%对16%，p<0.006），或在诊断前患有关节创伤（44%对19%，p<0.0002）。在疾病诊断前1年内，对照组报告的链球菌感染略多（p<0.2）、腹泻和呕吐感染（p<0.3）以及抗生素使用（p<0.09），尽管这些结果均无统计学意义。两组之间任何肝炎、风疹、任何细菌感染的病史以及既往结核菌素皮肤试验呈阳性的情况无显著差异，实际上对照组报告的情况更多见。SSc患者报告的乙型肝炎略多（p<0.08）、过去患风湿热略多（p<0.8）以及带状疱疹略多（p<0.4），尽管差异均未达到显著水平。