Autoantibody levels are associated with acute kidney injury, anemia and post-discharge morbidity and mortality in Ugandan children with severe malaria

Juan Rivera-Correa, Andrea L. Conroy, Robert O. Opoka, Anthony Batte, Ruth Namazzi, Benson Ouma, Paul Bangirana, Richard Idro, Andrew L. Schwaderer, Chandy C. John, Ana Rodriguez

Research output: Contribution to journalArticle

Abstract

Autoantibodies targeting host antigens contribute to autoimmune disorders, frequently occur during and after infections and have been proposed to contribute to malaria-induced anemia. We measured anti-phosphatidylserine (PS) and anti-DNA antibody levels in 382 Ugandan children prospectively recruited in a study of severe malaria (SM). High antibody levels were defined as antibody levels greater than the mean plus 3 standard deviations of community children (CC). We observed increases in median levels of anti-PS and anti-DNA antibodies in children with SM compared to CC (p < 0.0001 for both). Children with severe malarial anemia were more likely to have high anti-PS antibodies than children with cerebral malaria (16.4% vs. 7.4%), p = 0.02. Increases in anti-PS and anti-DNA antibodies were associated with decreased hemoglobin (p < 0.05). A one-unit increase in anti-DNA antibodies was associated with a 2.99 (95% CI, 1.68, 5.31) increase odds of acute kidney injury (AKI) (p < 0.0001). Elevated anti-PS and anti-DNA antibodies were associated with post-discharge mortality (p = 0.031 and p = 0.042, respectively). Children with high anti-PS antibodies were more likely to have multiple hospital readmissions compared to children with normal anti-PS antibody levels (p < 0.05). SM is associated with increased autoantibodies against PS and DNA. Autoantibodies were associated with anemia, AKI, post-discharge mortality, and hospital readmission.

Original languageEnglish (US)
Article number14940
JournalScientific reports
Volume9
Issue number1
DOIs
StatePublished - Dec 1 2019

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Phosphatidylserines
Acute Kidney Injury
Autoantibodies
Malaria
Anemia
Antinuclear Antibodies
Morbidity
Mortality
Patient Readmission
Anti-Idiotypic Antibodies
Cerebral Malaria
Antibodies
Hemoglobins
Antigens
DNA
Infection

ASJC Scopus subject areas

  • General

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Autoantibody levels are associated with acute kidney injury, anemia and post-discharge morbidity and mortality in Ugandan children with severe malaria. / Rivera-Correa, Juan; Conroy, Andrea L.; Opoka, Robert O.; Batte, Anthony; Namazzi, Ruth; Ouma, Benson; Bangirana, Paul; Idro, Richard; Schwaderer, Andrew L.; John, Chandy C.; Rodriguez, Ana.

In: Scientific reports, Vol. 9, No. 1, 14940, 01.12.2019.

Research output: Contribution to journalArticle

Rivera-Correa, J, Conroy, AL, Opoka, RO, Batte, A, Namazzi, R, Ouma, B, Bangirana, P, Idro, R, Schwaderer, AL, John, CC & Rodriguez, A 2019, 'Autoantibody levels are associated with acute kidney injury, anemia and post-discharge morbidity and mortality in Ugandan children with severe malaria', Scientific reports, vol. 9, no. 1, 14940. https://doi.org/10.1038/s41598-019-51426-z
Rivera-Correa, Juan ; Conroy, Andrea L. ; Opoka, Robert O. ; Batte, Anthony ; Namazzi, Ruth ; Ouma, Benson ; Bangirana, Paul ; Idro, Richard ; Schwaderer, Andrew L. ; John, Chandy C. ; Rodriguez, Ana. / Autoantibody levels are associated with acute kidney injury, anemia and post-discharge morbidity and mortality in Ugandan children with severe malaria. In: Scientific reports. 2019 ; Vol. 9, No. 1.
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