Correlation between circulating immune complexes and expression of extracardiac manifestations in infective endocarditis

Abstract

Background: Infective Endocarditis is a serious infection of the heart endocardium, particularly the heart valves are associated with a high degree of illness and death. It generally occurs in patients with altered and abnormal heart architecture, in combination with exposure to bacteria through trauma and other potentially high-risk activities involving transient bacteremia. Endocarditis remains a devastating disease with a high mortality despite timely diagnosis and treatment. Objective: to establish the correlation between circulating immune complexes and the degree of expression of extracardiac manifestations in infective endocarditis and it’s utility in nowadays diagnosis.Patients and methods: To examine the role of circulating immune complexes (CIC) in infective endocarditis, we studied 51 patients with infective endocarditis (IE) for the presence of CIC, from the Institute of Cardiology from Chisinau, the Republic of Moldova. We have used ELISA method, as the elective method to identify the level of CIC. We also included in this study, the clinical examination of the patients both with normal and high levels of CIC. Results: We identified 42 patients with a high-level of CIC and 9 pacients with a normal value of CIC. Among the pacients with high-level of CIC 35 (83.3% ) had subacute endocarditis (SBE), and 7 (16.7 %) had acute infective endocarditis(AIE). Systemic deposition of immune complexes results in the vasculitic lesions clasically associated with IE: so 8 (19.04%) had peripheral lesions (Osier’s nodes, petechiae, splinter hemorrhages et.al), and 31 (80.96%) had severe immunological manifestations such as: glomerulonephritis, mycotic anevrysms.et.al. Conclusion: These findings support the hypothesis that CIC may be important in the pathogenesis of peripheral and imunological lesions in infective endocarditis.