Cystatin C as a marker of immune complex-associated renal impairment in a Sudanese population with visceral leishmaniasis.
Renal function was studied in visceral leishmaniasis (VL) and post-kala-azar dermal leishmaniasis (PKDL) by means of the specific marker cystatin C and related to circulating immune complexes and cytokine production. Forty patients with VL (23 with sub-acute disease and 17 with acute disease), 17 patients with PKDL, and 22 healthy controls were included. Cystatin C, but not creatinine, was significantly raised in VL (P = 0.004). The highest levels of cystatin C were found in those with acute disease (P < 0.0001). In VL, cystatin C levels were positively correlated to circulating immune complexes and production of granulocyte-macrophage colony stimulating factor (GM-CSF), but negatively correlated to aspartate aminotransferase and lactate dehydrogenase. We conclude that cystatin C is a superior marker of glomerular function in leishmaniasis and that immune complex deposition and GM-CSF are two functions that most likely are causally involved in the mechanisms leading to glomerular dysfunction in leishmaniasis.
ElShafie
Amir Ibrahim
AI
Department of Clinical Pathology and Microbiology, Alribat University Hospital, Khartoum, Sudan. amirel1970@hotmail.com
Elghazali
Gehad
G
Rönnelid
Johan
J
Venge
Per
P
D000913:Antibodies, Protozoan / Q000097:blood; D000953:Antigens, Protozoan / Q000276:immunology*; D015415:Biomarkers / Q000097:blood; D055316:Cystatin C; D015891:Cystatins / Q000032:analysis*; D007898:Leishmaniasis, Visceral / Q000175:diagnosis* / Q000276:immunology; D010274:Parasitology / Q000379:methods; D051437:Renal Insufficiency; D013397:Sudan / Q000453:epidemiology
D000913:Antibodies, Protozoan; D000953:Antigens, Protozoan; D015415:Biomarkers; D055316:Cystatin C; D015891:Cystatins