Blackett K, Ngu J L
Br Heart J. 1976 Jun;38(6):605-11. doi: 10.1136/hrt.38.6.605.
Significantly higher levels of immunoconglutinin were found in the sera of 40 Cameroonian patients aged between 15 and 80 years with congestive cardiomyopathy than in a matched group of normal Cameroonian controls. C3 values were also abnormal in the group with congestive cardiomyopathy, and a negative correlation was found between the C3 and immunoconglutinin values, indicating complement incorporation into immune complexes. Further, the levels of immunoglobulins G, M, and A were all raised, the most striking increase being of IgM, which was greater than in the normal controls and in a group with 'other cardiac disease' studied for comparison. Complement-fixing autoantibodies to cardiac muscle of the class IgG and IgM were found by immunofluorescence techniques in a significant proportion of the patients with congestive cardiomyopathy. Finally, evidence of trypanosomiasis was found by immunofluorescence tests in 27-5 per cent of patients with congestive cardiomyopathy, compared with 8-5 per cent of patients with other cardiac disease, and 1-9 per cent of normal Cameroonian controls selected randomly. We think that some cases of congestive cardiomyopathy in Cameroon may be caused by untreated subclinical attacks of African trypanosomiasis which produce immune complexes that damage the cardiac tissue where the parasite is lodged. Secondary autoimmune carditis modifies the course of the disease, with the resulting end-stage picture.
在40名年龄在15至80岁之间患有充血性心肌病的喀麦隆患者血清中，发现免疫粘连素水平显著高于匹配的喀麦隆正常对照组。充血性心肌病组的C3值也异常，且C3与免疫粘连素值之间呈负相关，表明补体掺入免疫复合物。此外，免疫球蛋白G、M和A水平均升高，最显著升高的是IgM，其升高幅度大于正常对照组以及用于比较研究的“其他心脏病”组。通过免疫荧光技术在相当一部分充血性心肌病患者中发现了IgG和IgM类的心肌补体结合自身抗体。最后，通过免疫荧光试验发现，27.5%的充血性心肌病患者有锥虫病证据，相比之下，其他心脏病患者为8.5%，随机选取的喀麦隆正常对照组为1.9%。我们认为喀麦隆的一些充血性心肌病病例可能是由未经治疗的非洲锥虫病亚临床发作引起的，这种发作会产生免疫复合物，损害寄生虫寄生的心脏组织。继发性自身免疫性心肌炎会改变疾病进程，导致最终的终末期表现。
