[Seroimmunological profile of kala-azar in Tunisia].

165 sera of patients suffering from kala-azar were collected before and after treatment (N-methyl glucamine: Glucantime ) and analysed for anti-leishmania antibodies by the counter immunoelectrophoresis and fluorescent antibody techniques. Serum immunoglobulins G, A, M and Complement C4 and C3 were studied as well; and C reactive protein, rheumatoid factor and anti-nuclear, anti-mitochondrial and anti-smooth muscle antibodies were investigated. Before treatment, counter immuno-electrophoresis was positive in 63.88% and immunofluorescent antibody test in 94.6%. The analysis of immunoglobulins has shown an increase of IgG in nearly all cases, an increase of IgM in 78.26% of sera tested. Little change has been noted with IgA. C reactive protein has been found in 87.67% and rheumatoid factor in 76.4% of sera examined. In 4 patients, anti-smooth muscle antibodies have been found at a relatively weak dilution. A decrease of complement C4 has been observed whereas complement C3 was slightly increased. After treatment (2 cures of Glucantime ) counter immunoelectrophoresis was positive in 23.07% of cases whereas immunofluorescent antibody test was still positive in 84.62%. IgG remained increases in the whole cases and IgM in only 43,48%. C reactive protein and rheumatoid factor have been found in 14.81% and 50% of cases respectively. Complement C4 remained low whereas complement C3 showed normal mean value. The relationship between the serological disturbances observed and the prognosis were discussed.