Introduction
The visceral leishmaniosis (VL), or Calazar, is a chronic severe systemic disease,
potentially fatal to humans. Currently, VL is the prototype of a specific immune dysfunction
resulting from parasitism of leishmania donovani in macrophages, producing a broad
spectrum of clinical and immunological reversible only with specific treatment. Serum
Analysis from infected adult patients demonstrated the presence of autoantibodies
against cellular and humoral components, and circulating immune complexes.
Objectives
To identify the profile of autoantibodies in pediatric patients with VL and its correlation
with clinical outcome.
Methods
Through a transversal study, was investigated the occurence of autoantibodies ( antinuclear
antibodies (ANA), anti-DNA , anti-SM , anti-RNP , anti-SSb , anti-SSa, lupus anticoagulant,
IgG and IgM anticardiolipin (aCL) antibodies ) in 34 patients (under 18 years) with
diagnosis of VL, at the beginning and shortly after treatment, in the period October
2010 to March 2011.
Results
The incidence of autoantibodies present at the beginning in patients with VL was 64,7%
(10 with ANA positive (29,4%), 7 with lupus anticoagulant antibodies positive (20,58%),
8 with IgM aCL antibodies positive (23,5%) and 5 with IgG aCL antibodie positive (14,7%)
and 1 with Anti-RNP (2,9%). Sex, age, visceromegaly, nutritional status, treatment,
use of corticosteroids, infections, hemophagocytic syndrome, febrile neutropenia,
hemoglobin level and platelet count parameters were correlated with the presence of
antibodies (table:1). It was found associated anaemia (p<0,05) with the antibody presence,
but more studies are needed to evaluate the presence of hemolytic anemia associated.
Infections: sepsis, pneumonia and urinary tract infection in 71,42% of total patients,
but not correlated with antibodies. Autoimmunity was greatly reduced after treatment;
the statistical significance remained after stratification in ANA.
Conclusion
Visceral leishmaniasis appears to correlate positively with the presence of ANA, lupus
anticoagulant, IgG ang IgM aCL, in children, as in adults possibly by triggering a
systemic humoral response of Th2. We found association statistically significant with
lower hemoglobin level in these patients. Further studies are needed to evaluate the
antibodies pattern in these infections.
Disclosure of interest
None declared.