Endomyocardial fibrosis in Egypt: Is there any relation to schistosomiasis

ABSTRACT

The aim of this work was to study the profile of antibodies specific to Schistosoma mansoni worm and egg antigens in the serum and pericardial fluid in patients with endomyocardial fibrosis EMF. The study was conducted on nine of our patients previously diagnosed as EMF by 2D echocardiography and cardiac catheterization. Pericardiocentecis and analysis of pericardial fluid was done for all patients. Measurement of specific immunoglobulins G, M and A for soluble worm antigen preparation [SWAP] and soluble egg antigen [SEA] in the serum and pericardial effusion was done using an enzyme linked immunosorbent assay furthermore, SWAP specific IgG in serum and pericardial fluid was fractionated by enzyme immunoblot assay. All patients had specific SWAP and SEA IgG in their sera and pericardial fluid. SWAP IgM was negative in all sera but positive in pericardial fluid of three patients. SEA IgM was positive in four serum samples and six pericardial fluid samples. SWAP and SEA IgA was negative in all samples. There was statistical disagreement between the serum and pericardial anti SEA IgM suggesting the possibility of its local cardiac production. This study confirms the presence of antibodies specific to S.mansoni antigens in the serum and pericardial fluid of patients with EMF and suggests that EMF in Egypt is an immunologicaly mediated lesion of S.mansoni