Antiphospholipid antibodies and Mycoplasma pneumoniae infection

Abstract

Summary:Anticardiolipin antibody levels were measured in 57 patients with Mycoplasma pneumoniae infection and 21 patients with other infections. Significantly more patients in the mycoplamsa group had increased IgM and IgG anticardiolipin. Within the mycoplasma group significantly higher titres were found in patients with severe infection (assessed by need for hospital admission) and in patients with cold agglutinins. A tendency for particularly high titres to occur in patients with extra-pulmonary complications was identified.

Mycoplasma pneumoniae as an Under- Recognized Agent of Vasculitic Disorders

“…A single case of facial nerve palsy in association with M. pneumoniae infection with production of antiphospholipid antibodies has been reported [Snowden et al, 1990]. This suggests that vasculopathy of the peripheral vessels resulting from the production of these autoantibodies leading to neural damage can be a cause of cranial, and possibly also peripheral, nerve palsies.…”

“…Stroke can occur in children [Fu et al, 1998;Lee et al, 2009;Leonardi et al, 2005;Ovetchkine et al, 2002;Parker et al, 1981;Tanir et al, 2006;Visudhiphan et al, 1992] as well as in adults [Mulder & Spierings, 1987;Padovan et al, 2001;Senda et al, 2010;Snowden et al, 1990;Sočan et al, 2001;Sotgiu et al, 2003]. The middle cerebral arteries are most often affected [Fu et al, 1998;Leonardi et al, 2005;Mulder & Spierings, 1987;Parker et al, 1981;Senda et al, 2010;Sotgiu et al, 2003], though the internal carotid arteries are affected in a few cases Tanir et al, 2006;Visudhiphan et al, 1992].…”

“…The middle cerebral arteries are most often affected [Fu et al, 1998;Leonardi et al, 2005;Mulder & Spierings, 1987;Parker et al, 1981;Senda et al, 2010;Sotgiu et al, 2003], though the internal carotid arteries are affected in a few cases Tanir et al, 2006;Visudhiphan et al, 1992]. Although the presence of systemic hypercoagulable state has been reported in a few cases, evidenced by disseminated intravascular coagulation [Mulder & Spierings, 1987] or by the production of antiphospholipid (anticardiolipin) antibodies [Senda et al, 2010;Snowden et al, 1990;Tanir et al, 2006], most cases occur in the absence of such conditions. Accordingly, many authors have suggested the presence of local vasculitis leading to vascular occlusion as an etiology.…”

“…Macrophages, following phagocytosis of the organism, present these various kinds of mycoplasmal antigens to immunocompetent cells causing immune modulation which subsequently elicits autoimmunity through these antigens' molecular mimicry of various human cell components [for review, see Yang et al, 2004;Waites & Talkington, 2004]. From the perspective of vasculopathy due to M. pneumoniae, the most important aspect of this process must be the production of antiphospholipid (anticardiolipin) antibodies [Graw-Panzer et al, 2009;Nagashima et al, 2010;Snowden et al, 1990;Witmer et al, 2007]. Production of these antibodies is well known to occur during the course of autoimmune disorders such as systemic lupus erythematosus and to induce hypercoagulable state resulting in vasculopathy.…”

Presence of Antibodies Against Mycoplasma penetrans in Patients with Antiphospholipid Syndrome

“…Furthermore, many clinical criteria for APS have also been well documented in patients with M. pneumoniae infection, including Guillain-Barré-like illness and other central nervous system manifestations, hemolytic anemia, positive Coombs test, thrombocytopenia, and arthritis. [Asherson et al, 1994;Snowden et al, 1990;Yáñez et al, 1999].  Snowden et al (1990) found antiphospholipid antibodies in more than 50% of patients with M. pneumoniae pneumonia, especially those with severe infections requiring hospitalization.…”