Myositis-specific autoantibodies in a non-traveler, patient from a non-endemic country, with Plasmodium vivax malaria

Maja Stojanovic; Aleksandra Barac; Rada Miskovic; Dragana Jovanovic; Jasna Bolpacic; Jelena Ljubicic; Goran Stevanovic; Snezana Jovanovic; Andrija Bogdanovic

doi:10.3855/jidc.18482

Myositis-specific autoantibodies in a non-traveler, patient from a non-endemic country, with Plasmodium vivax malaria

Authors

Maja Stojanovic Clinic of Allergy and Immunology, University Clinical Center of Serbia, Belgrade, Serbia https://orcid.org/0000-0003-4589-7344
Aleksandra Barac University of Belgrade, Faculty of Medicine, Belgrade, Serbia
Rada Miskovic Clinic of Allergy and Immunology, University Clinical Center of Serbia, Belgrade, Serbia https://orcid.org/0000-0003-0982-2572
Dragana Jovanovic Clinic of Allergy and Immunology, University Clinical Center of Serbia, Belgrade, Serbia
Jasna Bolpacic Clinic of Allergy and Immunology, University Clinical Center of Serbia, Belgrade, Serbia
Jelena Ljubicic University of Belgrade, Faculty of Medicine, Belgrade, Serbia https://orcid.org/0009-0001-6471-2037
Goran Stevanovic University of Belgrade, Faculty of Medicine, Belgrade, Serbia https://orcid.org/0000-0002-3621-4882
Snezana Jovanovic Department of Microbiology, University Clinical Center of Serbia, Belgrade, Serbia https://orcid.org/0000-0001-8810-8363
Andrija Bogdanovic University of Belgrade, Faculty of Medicine, Belgrade, Serbia https://orcid.org/0000-0002-8288-7308

DOI:

https://doi.org/10.3855/jidc.18482

Keywords:

malaria, autoantibody, myositis, Plasmodium vivax

Abstract

Introduction: Autoantibodies (AAb) are a hallmark of immune-mediated inflammatory diseases. Malaria is a parasitic disease caused by Plasmodium protozoa. Individuals with malaria may present with a wide range of symptoms. It is frequently linked to the development of different AAb.

Case description: A 35-year-old male presented with repeated episodes of fever, malaise, myalgia, dark urine, and yellowish sclera. Initial diagnostic workup revealed severe Coombs-positive anemia, increased C-reactive protein, and procalcitonin, pathological liver tests, high concentration of serum IgE, IgG, IgM, IgA, positive antinuclear antibodies (ANA), and positive antineutrophil cytoplasmatic antibodies (ANCA). In addition, myositis-specific antibodies directed to polymiositis-scleroderma 75 protein (PmScl75), threonyl-tRNA synthetase (PL-7), alanyl-tRNA synthetase (PL-12), Mi-2 antigen (Mi-2), Ku DNA helicase complex (Ku), signal recognition particle (SRP), and antiaminoacyl tRNA synthetase (EJ) were detected. The patient was suspected of having systemic lupus erythematosus and sent to the Clinic of Allergy and Immunology for further evaluation and treatment. A peripheral blood film examined by the hematologist during an episode of fever revealed intra-erythrocytic parasitic forms of Plasmodium vivax (P. vivax). After being diagnosed with P. vivax malaria, he was transferred to the Clinic for Infective and Tropical Diseases. The therapy consisted of artesunate/mefloquine and prednisone led to a complete clinical recovery and autoantibodies gradually disappeared.

Conclusions: Malaria would not normally be considered during the initial diagnostic workup in a non-traveler and a patient from a non-endemic country. However, a thorough parasitic evaluation in patients presenting with a broad range of autoantibodies might be of particular importance.

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Published

2023-10-31

How to Cite

Stojanovic M, Barac A, Miskovic R, Jovanovic D, Bolpacic J, Ljubicic J, Stevanovic G, Jovanovic S, Bogdanovic A (2023) Myositis-specific autoantibodies in a non-traveler, patient from a non-endemic country, with Plasmodium vivax malaria. J Infect Dev Ctries 17:1497–1500. doi: 10.3855/jidc.18482

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Issue

Vol. 17 No. 10: October 2023

Section

Case Reports

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