Frequência de autoanticorpos e dosagem de complemento sérico em pacientes com diagnóstico de leishmaniose cutânea ou visceral

Abstract

Introduction: Leishmaniasis is a chronic infectious disease whose spectrum can vary from isolate cutaneous involvement with oligosymptomatic manifestations to systemic involvement with clinically important manifestations. The development of the infection of each type of leishmaniasis (visceral or cutaneous) depends on a complex and intriguing interaction between virulence factors of the pathogen and the immune response of the host. Analysis of sera of with Leishmania infection demonstrates the presence of autoantibodies against cellular and humoral components, besides circulating immune complexes and anti-IgG antibodies (rheumatoid factor). Patients with visceral leishmaniasis can present symptoms that mimic Systemic Lupus Erythematosus (SLE), hindering early diagnosis and treatment. Objectives: To identify the profile of autoantibodies and complement levels of patients with visceral or cutaneous leishmaniasis and to correlate their clinical presentation to those of patients with SLE. Methods: The presence of autoantibodies and complement levels of 90 patients, 45 with visceral leishmaniasis and 45 with cutaneous leishmaniasis, was determined. Results: The presence of statistically significant autoantibodies in patients with visceral leishmaniasis included: antinuclear antibody (ANA), positive (4.4%) or in low titers (8.9%), and IgG anticardiolipin antibody, positive (17.8%) or undetermined (8.9%). A reduction in C3 levels was also seen in 17.8% of the patients and anti-Leishmania antibodies > 1/80 in all patients with visceral leishmaniasis. Conclusions: Visceral leishmaniasis can have a positive correlation with the presence of autoantibodies, possibly by triggering a predominantly humoral, systemic, type Th2 response, representing an obligatory differential diagnosis with SLE, especially in endemic areas.