High plasma levels of adrenomedullin in collagen diseases

Background: Some immunologic mechanisms of epilepsy are cited in literature. The possibility that epilepsy might be associated with the production of autoantibodies has not been sufficiently addressed. Objective: This study investigates the prevalence of some antiphospholipid antibodies in pediatric primary epilepsy in relation to the type of seizures, the duration of the disease and the antiepileptic drugs received. Methods: The study included 37 patients in the pediatric age groups with epilepsy (30 with idiopathic epilepsy and 7 with cryptogenic epilepsy); 10 of them were newly diagnosed in comparison to ten healthy children. The patients were subjected to clinical, laboratory and radiologic evaluation to verify the diagnosis and to exclude thrombotic or autoimmune collagen disorders. Anticardiolipin IgG and IgM and anti-β 2 -glycoprotein I IgG and IgM antibodies were measured in all subjects using the ELISA technique. Results: Forty percent of the patients were positive for at least one of the antiphospholipid antibodies and 16% displayed more than one antibody in their serum. The mean values of anti CL IgG and anti β 2 GP I IgM were significantly higher in the patients (mean 11.32 ± 6.3 GPL and 4.43 ± 2.8 U/ml, respectively) as compared to the control group (mean 5.25 ± 1.9 and 1.6 ± 0.6, respectively) (P < 0.001). The concentrations of the tested antibodies were comparable among patients with focal compared to those with generalized seizure, or in patients with idiopathic compared to cryptogenic epilepsy. Patients with newly diagnosed untreated epileptic seizures showed a substantial prevalence of antiphospholipid antibodies. They even demonstrated significantly higher mean values of aβ2GP I IgG (10.7 ± 11 GPL) and aβ2GP I IgM (5.8 ± 3.0 U/ml) when compared to the rest of the patients (mean 5.9 ± 3.5 and 3.9 ± 2.6 respectively).There seem to be no effect of the different antiepileptic drugs or the degree of seizure control on the development of antiphospholipid antibodies. Conclusions: The antiphospholipid antibodies seem to be present at a higher rate in pediatric patients with epilepsy. The increased prevalence of those autoantibodies is associated with epilepsy regardless of the type of seizures, the antiepileptic drugs used or the degree of seizure control, suggesting that immune dysregulation may be linked to the pathogenesis of primary epilepsy. Keywords: anti β2 glycoprotein ; anticardiolipin; antiphospholipid; epilepsy; immune system Egypt J Pediatr Allergy Immunol 2004; 2(1): 58-65