Antibodies to anionic phospholipids and cofactors in kala-azar. Comparative study with malaria, toxoplasmosis and "autoimmune diseases".

Clin Exp Rheumatol

Laboratoire d'hématologie et banque du sang (03/UR/0818). CHU Sahloul. 4000 Sousse. Tunisia.

Published: April 2009

Objective: To investigate the distribution of various anti-anionic and anti-cofactor phospholipid antibodies in children with kala-azar, and to compare them to malaria, toxoplasmosis and auto-immune disease.

Patients And Methods: The frequency and the concentration of antibodies against cardiolipin (aCL), phosphatidylserine (aPS), phosphatidylinositol (aPI), phosphatidic acid (aPA), Beta2GPI (anti-Beta2GPI), prothrombin (aPT), annexin V (aAnnV), protein C (aPnC) and protein S (aPnS) were studied in sera from 103 children with kala-azar and compared with malaria (n=32), toxoplasmosis (n=31), systemic lupus erythematosus (SLE) (n=40) and antiphospholipid syndrome (APS) (n=35).

Results: The prevalence of aCL, aPS, aPI, aPA, anti-Beta2GPI, aPT, aAnnV, aPnC and aPnS was 54%, 56%, 43%, 28%, 73%, 67%, 55%, 30%, 25%, respectively. Ninety-three per cent of children with kala-azar (96/103) had one or more aPL specificities, but none had thromboses. The spectrum of aPL was quite similar to that found in patients with SLE and APS.

Conclusion: Antiphospholipid antibodies are a frequent finding in kala-azar. The aPL produced mimic those found in autoimmune disease. However, further studies are required to assess the exact role of these aPL during leishmaniasis.

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