Clinical significance of antinuclear antibodies, anti-neutrophil cytoplasmic antibodies and anticardiolipin antibodies in heroin abusers.
BACKGROUND
Different autoantibodies and immunologic abnormalities have been described in heroin abusers positive for human immunodeficiency virus, hepatitis B surface antigen, or hepatitis C virus, as well as in addicts with negative viral markers.


OBJECTIVE
To investigate the prevalence of different autoantibodies in heroin addicts.


METHODS
We studied 10 heroin addicts (8 males and 2 females aged 18-30 years) with a mean duration of heroin abuse of 46.5 months (range 6-96) for the presence of the following autoantibodies: antinuclear antibodies and anti-neutrophil cytoplasmic antibodies--using indirect immunofluorescent technique; ds-DNA, ss-DNA, Sm, RNP, Ro and La antibodies--using counter immunoelectrophoresis; and immunoglobulins G and M anticardiolipin and beta 2-glycoprotein-I antibodies--using enzyme-linked immunosorbent assay. All patients were tested for VDRL, HIV, HBsAG and anti-HCV antibodies.


RESULTS
Four patients were positive for ANA, of whom two were positive for anti-HCV and two for ANCA. Three patients were positive for IgM aCL, one of whom was positive for IgG beta 2 GPI with clinical data of acute renal failure in the course of heroin coma and antiphospholipid syndrome (deep vein thrombosis) and positive Sm and ds-DNA antibodies, and another had subacute endocarditis and biopsy-proven chronic tubulo-interstitial nephritis (in both these patients aCL gradually fell to normal levels after the cessation of heroin abuse). One patient was HBsAG positive with negative autoantibodies. All patients were HIV and VDRL negative.


CONCLUSIONS
Our data support the importance of ANA and aCL determination as a predictor of some systemic complications in heroin addicts.
Nikolova
Milena
M
Nephrology Clinic, Department of Internal Medicine, University Alexandrovska Hospital, Faculty of Medicine, Sofia, Bulgaria. milenchenceto@yahoo.com
Liubomirova
Mila
M
Iliev
Andrei
A
Krasteva
Rumiana
R
Andreev
Emil
E
Radenkova
Julia
J
Minkova
Violina
V
Djerassi
Regina
R
Kiperova
Boriana
B
Vlahov
Iordan D
ID
D000293:Adolescent; D000328:Adult; D017153:Antibodies, Anticardiolipin / Q000097:blood*; D019268:Antibodies, Antineutrophil Cytoplasmic / Q000097:blood*; D000974:Antibodies, Antinuclear / Q000097:blood*; D003378:Counterimmunoelectrophoresis; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D019084:Fluorescent Antibody Technique, Indirect; D006509:Hepatitis B / Q000097:blood* / Q000150:complications / Q000175:diagnosis / Q000276:immunology*; D006526:Hepatitis C / Q000097:blood* / Q000150:complications / Q000175:diagnosis / Q000276:immunology*; D006556:Heroin Dependence / Q000097:blood* / Q000150:complications / Q000175:diagnosis / Q000276:immunology*; D006801:Humans; D007674:Kidney Diseases / Q000097:blood* / Q000150:complications / Q000175:diagnosis / Q000276:immunology*; D008297:Male; D011237:Predictive Value of Tests; D012720:Severity of Illness Index; D013997:Time Factors
D017153:Antibodies, Anticardiolipin; D019268:Antibodies, Antineutrophil Cytoplasmic; D000974:Antibodies, Antinuclear