Klinički tok infekcije koksakivirusom B (1-6)
Introduction: Coxsackie B viral infections are the usual infections of children and adults. Clinical manifestations include fever, aseptic meningitis, pleurodinia, myocarditis, gastroenterocolitis, maculous exanthem. The clinical course of the infection is influenced by the characteristics of the host, as well as the virus serotype. The pathogenesis of the virus is explained by the immune mediated mechanism and the direct cytotoxic effect of the virus. Methods: Retrospectively analyzed virus serotype, clinical and biochemical date in patients with Coxsackie B viral infection. Autoantibodies were found in patients who had an unclear febrile status for more than 6 months.
Results: We examined a total of 378 patients with Coxsackie B viral infection, (302 women, 76 men), age 19 to 79 years. The dominant symptoms were weakness, elevated body temperature, fatigue and muscle aches. In 55% the clinical course was unclear febrile state, in 13% myalgia and/pleurodnia, after 9% acute gastroenterocolitis and acute myocarditis/pericarditis, 4% a septic meningitis and other respiratory disease, 3% acute pancreatitis and 1% diabetes mellitus. Autoantibodies were detected in 69% of patients with unclear febrile state. Antinuclear antibodies were most common, in 67%. In 36% of patients with antinuclear antibodies was detected serotyp B2, in 14% serotyp B4.
Conclusion: The most common clinical form of Coxsackie B viral infection is an unclear febrile state caused by a B2 serotype of the virus. In most of these patients, an elevated titre of antinuclear antibodies can be detected.
Muehlenbachs A, Bhatnagar J, Zaki SR. Tissue tropism, pathology and pathogenesis of enterovirus infection. The Journal of Pathology. 2014; 235(2): 217-28.
Rueckert RR. Picornaviridae: the viruses and their replication. In: Fields BN, Knipe DM & Howley PM, eds. Fundamental Virology. 3rd ed. Philadelphia, USA: Lippincott-Raven Publishers, 1996; 477-522.
Yeung WC, Rawlinson WD, Craig ME. Enterovirus infection and type 1 diabetes mellitus: Systematic review and meta-analysis of observational molecular studies. BMJ, 2011; 342: d35.
Tam PE, Fontana DR, Messner RP. Coxsackievirus B1-induced chronic inflammatory myopathy: differences in induction of autoantibodies to muscle and nuclear antigens by cloned myopathic and amyopathic viruses. J Lab Clin Med 2003; 142(3):196-204.
Triantafyllopoulou A, Tapinos N, Moutsopoulos HM. Evidence for coxsackievirus infection in primary Sjögren’s syndrome. Arthritis and rheumatism. 2004; 50(9):2897-902.
Tao Z, Li B, Xu A, Liu Y, Song L, Wang S, et al. Seroprevalence of Coxsackievirus B3 in Yantai, China. Jpn. J. Infect. Dis. 2013; 66(6): 537-8.
Mavrouli MD, Spanakis N, Levidiotou S, Politi C, Alexiou S, Tseliou P, et al. Serologic prevalence of coxsackievirus group B in Greece. Viral Immunol. 2007; 20(1):11-8.
Payment P. Antibody levels to selected enteric viruses in a normal randomly selected Canadian population. Immunology and Infectious Disease. 1991; 1:317-22.
Pallansch M, Roos, RP. 2001. Enteroviruses: Polioviruses, Coxsackieviruses, Echoviruses, and Newer Enteroviruses, 5th ed. Lippincott Williams & Wilkins, Philadelphia.
Vom Steeg LG, Klein SL. SeXX matters in infectious disease pathogenesis. PLoS Pathog. 2016; 12(2): e1005374.
Ozcelik T. X chromosome inactivation and female predisposition to autoimmunity. Clin Rev Allergy Immunol. 2008; 34(3): 348-51.
Cunha CB, Cunha BA. Differential diagnosis in infectious disease. In: Cunha CB, Cunha BA, editors. Antibiotic Therapy. 15th ed. New Delhi: Jay Pee Medical Publishing. 2016; p: 06-47.
Modlin JF. Coxsackieviruses, echoviruses, and newer enteroviruses. In: Mandel, Douglas, Bennets, eds. Principles and Practice of Infectious Diseases. 5th ed. Philadelphia: Churchill-Livingstone. 2000: 1904-19.
Čanović P, Mijailović Ž, Gavrilović J, Gajović O. Epidemijska pleurodinija - mogući imitator koronarne bolesti. Medicinski časopis. 2005; 39: 46-8.
Kearney MT, Cotton JM, Richardson PJ, Shah AM. Viral myocarditis and dilated cardiomyopathy: mechanisms, manifestations, and management. Postgrad Med J. 2001; 77(903):4-10.
Richardson SJ, Morgan NG. Enteroviral infections in the pathogenesis of type 1 diabetes: new insights for therapeutic intervention. Curr Opin Pharmacol. 2018; 43: 11-9.
Stene LC, Oikarinen S, Hyöty H, Barriga KJ, Norris JM, Klingensmith G, et al. Enterovirus infection and progression from islet autoimmunity to type 1 diabetes: the Diabetes and Autoimmunity Study in the Young (DAISY). Diabetes. 2010; 59(12):3174-80.
Thomas NJ, Jones SE, Weedon MN, Shields BM, Oram RA, Hattersley AT. Frequency and phenotype of type 1 diabetes in the first six decades of life: a cross-sectional, genetically stratified survival analysis from UK Biobank. Lancet Diabetes Endocrinol. 2018; 6(2):122-9.
Hyöty H, Leon F, Knip M. Developing a vaccine for type 1 diabetes by targeting coxsackievirus B. Expert Review of Vaccines. 2018; 17(12):1071-83.
Huber S, Ramsingh AI. 2004. Coxsackievirus-induced pancreatitis. Viral Immunol. 2004; 17(3):358-69.
Farris AB, PeturNielsen G. Genitourinary Infectious Disease Pathology. In: Kradin R. Diagnostic Pathology of Infectious Disease. 1st ed, Kindle Edition 2010; 403-41.
Valestra PK, Fornos SH, Gian J, Cunha BA. Coxsackie B5 infection in an adult with fever, truncal rash, diarrhea and splenomegaly with highly elevated ferritin levels IDCases. 2016; 6:14-6.
Drago F, Paolino S, Rebora A et al. The challenge of diagnosing atypical exanthems: a clinico-laboratory study. J. Am. Acad. Dermatol. 2012; 67:1282-8.
Tebruegge M, Curtis N. Enterovirus infections in neonates. Semin. Fetal Neonatal Med. 2009; 14(4):222-7.
Gullberg M, Tolf C, Jonsson N, Polacek C, Precechtelova J, Budarova M, et al. A Single Coxsackievirus B2 Capsid Residue Controls Cytolysis and Apoptosis in Rhabdomyosarcoma Cells. J Virol 2010; 84(12):5868-79.
Stathopoulou EA, Routsias JG, Stea EA, Moutsopoulos HM, Tzioufas AG. Cross-reaction between antibodies to the major epitope of Ro60 kD autoantigen and a homologous peptide of Coxsackie virus 2B protein. Clinical and experimental immunology. 2005; 141:148-54.
Chistensen ML, Pachman LM, Schneiderman R, Patel DC, Friedman JM.
Prevalence of Coxackie B virus antibodies in patients with juvenile dermatomyositis. Arthritis and Rheumatism. 1986; 29: 1365-70.
Chapman NM, Kim KS. Persistent coxsackievirus infection: enterovirus persistence in chronic myocarditis and dilated cardiomyopathy. Curr. Top. Microbiol. Immunol. 2008; 323:275-92.
Sane F, Moumna I, Hober D. Group B coxsackieviruses and autoimmunity: focus on Type 1 diabetes. Expert. Rev. Clin. Immunol. 2011; 7(3):357-66.
Whitton JL, Feuer R. Myocarditis, microbes and autoimmunity. Autoimmunity. 2004; 37:375-86.