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Serum immunoglobulins in children with cardiomyopathies
Insights
Infections may cause childhood heart conditions like dilated cardiomyopathy (DCM) and endomyocardial fibrosis (EMF). Higher immunoglobulin G (IgG) and E (IgE) levels in patients suggest a link between infections and these cardiac diseases.
Area of Science:
- Pediatric Cardiology
- Immunology
- Infectious Diseases
Background:
- Childhood cardiomyopathies, including dilated cardiomyopathy (DCM) and endomyocardial fibrosis (EMF), have complex etiologies.
- The role of infections in the development of these pediatric heart conditions requires further investigation.
Purpose of the Study:
- To assess the role of infections in the etiology of childhood cardiomyopathies by examining serum immunoglobulin levels.
- To compare immunoglobulin profiles in children with DCM, EMF, and rheumatic heart disease (RHD) against healthy controls.
Main Methods:
- Serum immunoglobulin G (IgG), A (IgA), M (IgM), and E (IgE) levels were measured in four groups of children: DCM, EMF, RHD, and age-matched controls.
- Statistical analysis was performed to compare immunoglobulin concentrations across the groups.
- Presence of intestinal helminths and degree of eosinophilia were assessed in EMF patients.
Main Results:
- Mean IgG concentrations were significantly higher in children with EMF, DCM, and RHD compared to controls.
- Mean serum IgE levels were elevated in EMF patients compared to RHD, DCM, and controls.
- Intestinal helminths and moderate eosinophilia were prevalent in most EMF patients, with high IgE levels observed in a significant subset.
Conclusions:
- Elevated IgG and IgE levels suggest that infections play a role in the pathogenesis of childhood cardiomyopathies like EMF and DCM, similar to RHD.
- Intense helminth-induced anaphylaxis is a potential cause of cardiac damage in endomyocardial fibrosis.
- Further research is warranted to elucidate the specific infectious agents and immune mechanisms involved in pediatric cardiomyopathies.
Abstract:
Serum immunoglobulins G, A, M and E were determined in four groups of children, including 14 patients with dilated cardiomyopathy (DCM), 17 with endomyocardial fibrosis (EMF), 18 with rheumatic heart disease (RHD) and 35 age-matched controls, in an attempt to assess the role of infections in the aetiology of childhood cardiomyopathies. Mean IgA and IgM concentrations in all four groups were not significantly different. However, mean IgG concentrations were higher in patients with EMF (1729 mg/100 ml), DCM (1745 mg/100 ml) and RHD (1978 mg/100 ml) than in controls (1429 mg/100 ml), and in about 30% of these cardiac patients the levels were higher than the 97th percentile for controls. In addition, mean serum IgE was higher in EMF (3577 iu/ml) than in RHD (2814 iu/ml), DCH (1000 iu/ml) or controls (1666 iu/ml), and in 29% of the EMF patients serum IgE exceeded 6834 iu/ml, the 89th percentile for controls. Intestinal helminths and moderate eosinophilia (mean count, 10%) were detected in most of the EMF patients. These results suggest that some cases of EMF and DCM are, like RHD, complications of infections, and that intense helminth-induced anaphylaxis is a probable cause of cardiac damage in such cases of EMF.