Rivera-Correa, JuanConroy, Andrea L.Opoka, Robert O.Batte, AnthonyNamazzi, RuthOuma, BensonBangirana, PaulIdro, RichardSchwaderer, Andrew L.John, Chandy C.Rodriguez, Ana2020-01-172020-01-172019-10-17Rivera-Correa, J., Conroy, A. L., Opoka, R. O., Batte, A., Namazzi, R., Ouma, B., … Rodriguez, A. (2019). Autoantibody levels are associated with acute kidney injury, anemia and post-discharge morbidity and mortality in Ugandan children with severe malaria. Scientific reports, 9(1), 14940. doi:10.1038/s41598-019-51426-zhttps://hdl.handle.net/1805/21874Autoantibodies targeting host antigens contribute to autoimmune disorders, frequently occur during and after infections and have been proposed to contribute to malaria-induced anemia. We measured anti-phosphatidylserine (PS) and anti-DNA antibody levels in 382 Ugandan children prospectively recruited in a study of severe malaria (SM). High antibody levels were defined as antibody levels greater than the mean plus 3 standard deviations of community children (CC). We observed increases in median levels of anti-PS and anti-DNA antibodies in children with SM compared to CC (p < 0.0001 for both). Children with severe malarial anemia were more likely to have high anti-PS antibodies than children with cerebral malaria (16.4% vs. 7.4%), p = 0.02. Increases in anti-PS and anti-DNA antibodies were associated with decreased hemoglobin (p < 0.05). A one-unit increase in anti-DNA antibodies was associated with a 2.99 (95% CI, 1.68, 5.31) increase odds of acute kidney injury (AKI) (p < 0.0001). Elevated anti-PS and anti-DNA antibodies were associated with post-discharge mortality (p = 0.031 and p = 0.042, respectively). Children with high anti-PS antibodies were more likely to have multiple hospital readmissions compared to children with normal anti-PS antibody levels (p < 0.05). SM is associated with increased autoantibodies against PS and DNA. Autoantibodies were associated with anemia, AKI, post-discharge mortality, and hospital readmission.en-USAttribution 4.0 InternationalInfectionAcute kidney injuryMalariaArticle