Universitas Muhammadiyah Sidoarjo
Login


Indonesian Journal on Health Science and Medicine

 Submit manuscript
Section Articles

Antinuclear Antibodies Elevated in Cutaneous Leishmaniasis Patients: Diagnostic Implications

Vol. 3 No. 1 (2026): July:
DOI : https://doi.org/10.21070/ijhsm.v3i1.378
Published : Jan 26, 2026

Noor Talal Ali (1), Shahad Saad Daham (2), Dema kamal Mustafa (3)

(1) College of Nursing, Tikrit University, Iraq
(2) College of Education for Pure Science, Tikrit University, Iraq
(3) College of Education for Pure Science, Tikrit University, Iraq
Fulltext View | Download

Abstract:

General Background: Leishmaniasis is a widespread parasitic disease transmitted by sandfly bites, posing significant public health challenges in developing countries, with cutaneous leishmaniasis being particularly prevalent in Iraq. Specific Background: While clinical diagnosis remains standard, immunological markers including specific antibodies (IgM, IgG) have been explored for cutaneous leishmaniasis detection, yet the diagnostic potential of antinuclear antibodies (ANA) remains underutilized. Knowledge Gap: The role of ANA as an immunological biomarker for cutaneous leishmaniasis diagnosis in Tikrit has not been comprehensively investigated. Aims: This serological study examined ANA levels and specific antibody responses in 60 clinically diagnosed cutaneous leishmaniasis patients at Tikrit Teaching Hospital from October 2023 to January 2024. Results: Males showed higher infection rates (53.33%) than females (46.66%); the 1-5 year age group exhibited the highest prevalence (31.66%); dry ulcers predominated (78.33%, p<0.01); 75% of patients demonstrated IgM antibodies, 5% showed IgG, and 20% tested negative; significantly, ANA levels were elevated in both male and female patients compared to controls (p<0.05). Novelty: This study establishes ANA as a valuable supplementary immunological marker for cutaneous leishmaniasis diagnosis in the Tikrit region. Implications: The findings suggest that ANA testing could enhance diagnostic accuracy and understanding of autoimmune responses in cutaneous leishmaniasis, potentially improving patient management strategies.
Keywords : Cutaneous Leishmaniasis, Antinuclear Antibodies, Immunological Markers, Serological Diagnosis, Tikrit Epidemiology
Highlight :



  • Dry ulcers predominated at 78.33%, significantly higher than wet ulcers at 21.66%.

  • Rural residents showed 71.66% infection rate compared to 43.33% in urban areas.

  • Seventy-five percent of patients exhibited IgM antibodies indicating acute infection phase.

References

S. J. M. Al-Hassani and A. I. M. Al-Bsherawee, "Epidemiological and Histological Study of Cutaneous Leishmaniasis in Humans in Al-Najaf Al-Ashraf Governorate," International Journal of Health Sciences, vol. 18, no. 1, pp. 24-34, 2022.

S. Mann, K. Frasca, and S. Scherrer, "A Review of Leishmaniasis: Current Knowledge and Future Directions," Current Tropical Medicine Reports, vol. 8, pp. 121-132, 2021.

W. S. Al-Zubaidi, "The Inhibitory Effect of the Alcoholic Extract of Neem Indica Azadirachta and Zinc Oxide Nanoparticles on the Leishmania Cutaneous Parasite," M.Sc. thesis, College of Veterinary Medicine, Tikrit University, Tikrit, Iraq, 2021.

M. H. Flaih, F. A. Al-Abady, and K. R. Hussein, "Phylogenetic Analysis of Kinetoplast DNA: KDNA of Leishmania Tropica in Thi-Qar Province, Iraq," Comparative Immunology, Microbiology and Infectious Diseases, vol. 78, art. 101696, 2021.

A. Balahbib, A. Hmamouch, A. El Allam, H. Douhri, N. Dahaieh, N. El Omari, and A. Bouyahya, "Cutaneous Leishmaniasis: Physiopathology, Molecular Diagnostic, and Therapeutic Approaches," Progress in Microbes and Molecular Biology, vol. 6, no. 1, 2023.

Q. Jamal, A. S, S. B. Rasheed, and M. Adnan, "In Vitro Assessment and Characterization of the Growth and Life Cycle of Leishmania Tropica," Pakistan Journal of Zoology, vol. 52, no. 2, pp. 447-455, 2020.

M. Fakhar, M. H. Motazedian, Q. Asgari, and M. Kalantari, "Asymptomatic Domestic Dogs Are Carriers of Leishmania Infantum: Possible Reservoirs Host for Human Visceral Leishmaniasis in Southern Iran," Comparative Clinical Pathology, vol. 21, no. 5, pp. 801-807, 2012.

A. K. Daham and T. I. Alousi, "An Epidemiological Survey of Cutaneous Mycosis in Salah Al-Din Governorate," Diyala Journal of Agricultural Sciences, vol. 3, pp. 601-610, 2011.

H. M. Obaid and H. A. Shareef, "Epidemiological and Clinical Study of Leishmaniasis in Kirkuk City, Iraq," Iraqi Journal of Science, vol. 59, no. 3A, pp. 1195-1204, 2018.

M. J. Al-Obaidi, M. Y. Abd Al-Hussein, and I. M. Al-Saqur, "Survey Study on the Prevalence of Cutaneous Leishmaniasis in Iraq," Iraqi Journal of Science, vol. 57, no. 3C, pp. 2181-2187, 2016.

M. K. Al-Hassani, "Epidemiological Molecular and Morphological Identification of Cutaneous Leishmaniasis and Its Insect Vectors in Eastern Al-Hamzah District, Al-Qadisiya Province," M.Sc. thesis, College of Science, University of Al-Qadisiya, Al-Qadisiya, Iraq, 2016.

J. A. K. Kadhim, "An Epidemiological and Diagnostic Study of Leishmaniasis with Updated Parasite Patterns and Identification of the Causative Sand Fly Species in Diyala Governorate," Ph.D. dissertation, College of Education for Technology, Tikrit University, Tikrit, Iraq, 2012.

R. S. S. Al-Difai, "The Spread of Cutaneous Leishmaniasis in Al-Qadisiyah Governorate with an Assessment of the Response to Treatment with Pentostam Using the RT-PCR Method," M.Sc. thesis, College of Education, Life Sciences, Al-Qadisiyah University, Al-Qadisiyah, Iraq, 2013.

A. K. Al-Nassiri and T. I. Al-Alousy, "Epidemiological Survey for Cutaneous Leishmaniasis in Salah El-Den Province," Diyala Agriculture Science Journal, vol. 3, no. 2, pp. 1-8, 2011.

M. J. Al-Rashid, A. H. Al-Jubouri, and F. S. Al-Nasiri, "A Study of Some Epidemiological Aspects and Hematological Parameters Associated with Cutaneous Leishmaniasis in Tikrit City," Tikrit Journal of Pure Sciences, vol. 20, no. 5, pp. 56-63, 2015.

F. A. Al-Abadi and N. A. Al-Mousawi, "An Epidemiological Study of Cutaneous Leishmaniasis in Infected Individuals in Dhi Qar Governorate," Journal of Education for Pure Sciences, vol. 6, no. 1, pp. 52-61, 2016.

Q. H. Al-Saadi, "Measuring the Cellular Kinetics of the Immune Response in Patients with Cutaneous Leishmaniasis," M.Sc. thesis, College of Education for Pure Sciences, University of Diyala, Diyala, Iraq, 2014.

L. E. Munstermann, "Phlebotomine Sand Flies, the Psychodidae," in Biology of Disease Vectors, W. C. Marquardt, B. C. Kondratieff, C. G. Moore, A. A. James, J. E. Freier, J. Hemingway, H. H. Hagedorn, and S. Higgs, Eds. Amsterdam: Elsevier, 2005, pp. 141-151.

H. Z. A. Abu Al-Dawaneej, "A Study of Some Epidemiological Aspects of Leishmaniasis and Diagnosis of the Parasite Using the Interfering Type Polymerase Chain Reaction Technique in Maysan Governorate/Iraq," M.Sc. thesis, College of Education for Pure Sciences, University of Basra, Basra, Iraq, 2014.

I. S. Musa, "Comparative Immune Study on Cutaneous Leishmaniasis Patients with Single and Multiple Sores," M.Sc. thesis, College of Science, University of Al-Qadisiyah, Al-Qadisiyah, Iraq, 2011.

K. A. Dawood and A. F. Al-Jeboori, "Pathological Study of Cutaneous Leishmaniasis in Al-Diwaniya Province," Al-Qadisiya Medical Journal, vol. 12, no. 21, pp. 6-15, 2016.

Q. B. Abdulla, N. P. Shabila, and T. S. Al-Hadithi, "An Outbreak of Cutaneous Leishmaniasis in Erbil Governorate of Iraqi Kurdistan Region in 2015," The Journal of Infection in Developing Countries, vol. 12, no. 8, pp. 600-607, 2018.

R. I. Salman, "Studying Some of the Immunological and Histological Effects in Patients of Cutaneous Leishmaniasis in Al-Najaf Al-Ashraf Governorate/Iraq," M.Sc. thesis, College of Education for Girls, University of Kufa, Kufa, Iraq, 2017.

N. Al-Mousawi, "Investigating Cutaneous Leishmaniasis and Determining the Role of Heat Shock Protein HSP70 in the Immune Response in Dhi Qar Governorate," M.Sc. thesis, College of Education for Pure Sciences, University of Dhi Qar, Dhi Qar, Iraq, 2015.

R. S. Al-Difaie and G. A. Jassem, "Study for the Detection of Cutaneous Leishmaniasis Parasite with Identifying the Type of Parasite and Diagnose the Most Important Histopathological Changes Accompanying the Parasite," Basrah Journal of Veterinary Research, vol. 11, no. 4, pp. 1-9, 2014.

A. B. M. Al-Waaly and H. W. K. Shubber, "Epidemiological Study of Cutaneous Leishmaniasis in Al-Diwaniyah Province, Iraq," Eurasian Journal of Biosciences, vol. 14, no. 1, pp. 269-273, 2020.

H. O. Alwan and Z. S. Al-Raziqi, "Estimation of Immunoglobulins (IgG, IgM) in the Serum of Patients with Cutaneous Leishmaniasis in Baghdad," Journal of the University of Kufa for Biological Sciences, vol. 11, no. 1, pp. 94-98, 2019.

A. M. Shaker and M. M. Jassim, "The Role of Antinuclear Antibodies (ANA) in the Diagnosis of Cutaneous Leishmaniasis in Samarra City," Journal of Medical Sciences, vol. 12, no. 3, pp. 45-52, 2019.

I. Roitt, J. Brodtoff, and D. Male, Immunology, 6th ed. London: Harcourt Publishers Ltd., 2001.

H. Ozbilge, N. Aksoy, M. S. Gurel, and S. Yazar, "IgG and IgG Sub Class Antibodies in Patients with Active Cutaneous Leishmaniasis," Journal of Medical Microbiology, vol. 55, pp. 1329-1331, 2006.

Z. T. Hussein, "Epidemiological Study on Prevalence of Cutaneous Leishmanasis Disease in Area of North Baghdad/Iraq, and Impact Statement of Infection on Some Immunological Parameters," M.Sc. thesis, Zagazig University, Zagazig, Egypt, 2017.

E. Lappas, A. Krasagakis, F. Apidianakis, and M. S. Elisaf, "Autoimmune Manifestations in Patients with Visceral Leishmaniasis," Journal of Microbiology, Immunology and Infection, vol. 46, pp. 302-305, 2013.

R. D. Pearson, D. A. Wheeler, L. H. Harrison, and H. D. Kay, "The Immunobiology of Leishmania," Reviews of Infectious Diseases, vol. 5, pp. 907-927, 1983.

N. Malla and R. C. Mahajan, "Pathophysiology of Visceral Leishmaniasis Some Recent Concepts," Indian Journal of Medical Research, vol. 123, pp. 267-274, 2006.