Nature and incidence of erythrocyte-bound IgG and some aspects of the physiopathogenesis of anaemia in American visceral leishmaniasis.

IgG molecules were found associated with erythrocyte membranes in all patients with American visceral leishmaniasis. They were detected by two different immunoradiometric assays and by one enzyme-linked immunosorbent assay. Although autoimmune phenomena seem to be constant features of American visceral leishmaniasis, the erythrocyte-bound IgG are not erythrocyte-specific autoantibodies. Moreover, anti-Leishmania activity was found associated with the erythrocyte-bound IgG, indicating that the IgG may be a component of Leishmania antigens-anti-Leishmania immune complexes. No associations were found between the amounts of erythrocyte-bound IgG and the degree of anaemia or between spleen dimensions and the degree of anaemia. These findings suggest that the pathogenesis of anaemia in American visceral leishmaniasis is multifactorial.

Annular subvalvular left ventricular aneurysm in Bahia, Brazil.

Two cases of left ventricular aneurysm, a 16-year-old black boy and a 23-year-old white girl, from Bahia, Brazil, are presented. In both patients there was enlargement of the cardiac silhouette and a prominent bulge of the left inferior border. On the right oblique view a ring of calcium at the ventricular opening of the aneurysms was visualized. A left ventriculogram showed a huge aneurysm in the first case and a bulge on the lateral wall of the left ventricle in the other. Cardiac catheterization showed a rise in left and right ventricular end-diastolic pressures and in the mean pulmonary artery pressure. In the first case the contour of the right ventricular pressure curve showed a restrictive pattern. The similarities of these aneurysms with the annular submitral type described in young black Africans are stressed.