The association of Neoehrlichia mikurensis infection with polymyalgia rheumatica
6 affiliations
- 1Department of Clinical Microbiology, Sahlgrenska University Hospital, Gothenburg, Sweden
- 2Department of Infectious Diseases, the Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- 3Research, Education, Development and Innovation Primary Health Care, Region Västra Götaland, Gothenburg, Sweden
- 4Department of Rheumatology and Inflammation Research, Institute of Medicine, the Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- 5General Practice/Family Medicine, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- 6Regionhälsan R&D Centre, Skaraborg Primary Care, Skövde, Sweden
Abstract
Neoehrlichia mikurensis is a tick-borne bacterium that can give rise to latent infections of vascular endothelium and PMR-like symptoms. PMR is an autoinflammatory or autoimmune condition of unknown cause that has been linked to infectious agents. The objective of this study was to investigate a possible association of PMR with N. mikurensis infection. Patients with PMR (n = 142) and matched control subjects (n = 56) from seven primary health care centers in West Sweden were tested for infection with N. mikurensis by PCR and serology. Patient-reported data regarding 31 PMR symptoms, tick exposure, past and current co-morbidities were registered. Anti-endothelial cell antibodies (AECA) and 38 inflammatory markers were measured in serum. The data was analyzed by multivariate methods of pattern recognition. There was no difference in the prevalence of infection with N. mikurensis between the PMR patients (5.6%) and the control subjects (5.4%). PMR patients infected with N. mikurensis differed from the non-infected PMR patients by their raised levels of IgM AECA and of interleukin-1β, and lower levels of insulin-like growth factor-binding protein 4, cystatin C and angiopoietin-1. Furthermore, there was a correlation between IgM antibodies to N. mikurensis and IgM AECA (r = 0.50, P < 0.0001). To conclude, PMR patients infected with N. mikurensis had vascular autoantibodies and a distinct inflammatory profile but whether the infection had triggered or modulated the development of PMR could not be established in the present study.
Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1007/s15010-026-02857-0.
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BibTeX
@article{lingblom2026association,
title = {{The association of Neoehrlichia mikurensis infection with polymyalgia rheumatica}},
author = {Christine Lingblom and Sofia Sundvall and Kerstin Andersson and Alaitz Aranburu and Kristina Bengtsson Boström and Per Hjerpe and Karin Mossberg and Pär-Daniel Sundvall and Christine Wennerås},
journal = {Infection},
year = {2026},
month = jul,
doi = {10.1007/s15010-026-02857-0},
url = {https://doi.org/10.1007/s15010-026-02857-0},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - The association of Neoehrlichia mikurensis infection with polymyalgia rheumatica
AU - Christine Lingblom
AU - Sofia Sundvall
AU - Kerstin Andersson
AU - Alaitz Aranburu
AU - Kristina Bengtsson Boström
AU - Per Hjerpe
AU - Karin Mossberg
AU - Pär-Daniel Sundvall
AU - Christine Wennerås
PY - 2026
DA - 2026/07/10
JO - Infection
DO - 10.1007/s15010-026-02857-0
UR - https://doi.org/10.1007/s15010-026-02857-0
AB - Neoehrlichia mikurensis is a tick-borne bacterium that can give rise to latent infections of vascular endothelium and PMR-like symptoms. PMR is an autoinflammatory or autoimmune condition of unknown cause that has been linked to infectious agents. The objective of this study was to investigate a possible association of PMR with N. mikurensis infection. Patients with PMR (n = 142) and matched control subjects (n = 56) from seven primary health care centers in West Sweden were tested for infection with N. mikurensis by PCR and serology. Patient-reported data regarding 31 PMR symptoms, tick exposure, past and current co-morbidities were registered. Anti-endothelial cell antibodies (AECA) and 38 inflammatory markers were measured in serum. The data was analyzed by multivariate methods of pattern recognition. There was no difference in the prevalence of infection with N. mikurensis between the PMR patients (5.6%) and the control subjects (5.4%). PMR patients infected with N. mikurensis differed from the non-infected PMR patients by their raised levels of IgM AECA and of interleukin-1β, and lower levels of insulin-like growth factor-binding protein 4, cystatin C and angiopoietin-1. Furthermore, there was a correlation between IgM antibodies to N. mikurensis and IgM AECA (r = 0.50, P < 0.0001). To conclude, PMR patients infected with N. mikurensis had vascular autoantibodies and a distinct inflammatory profile but whether the infection had triggered or modulated the development of PMR could not be established in the present study. Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1007/s15010-026-02857-0.
SN - 0300-8126
SN - 1439-0973
ER -