Background and aims Systemic lupus erythematosus is an autoimmune disorder characterised by elevated levels of autoantibodies. Association of specific autoantibodies with different clinical manifestations of SLE has been documented. Malaria infection is associated with raised levels of autoantibodies. It is not known what happens to autoantibody productions in SLE patients residing in malarial endemic areas and its association with disease manifestation. In the present study,we enrolled SLE patients residing in from different areas of Odisha state, Indiaand investigate possible association of P. falciparum endemicity with autoantibodies profile of SLEpatients.

Methods A total of 190 SLE patients from different districts of Odisha, which is endemic for P. falciparum malaria were enrolled in the present study. Clinically assessed, and autoantibodies levels were quantified by standard laboratory procedures. They were grouped as 1) Patients from low endemic area based on Annual Parasite Index (API) as low (API <4) and 2) High (API >4) and the data was analysed.

Results The mean age and disease duration of SLE patients were 28.44 and 1.67 years, respectively. 128 patients resided in lower endemic areas and 62 in high endemic areas. 62%of patients from higher endemic areas had nephritis and other major manifestations like NPSLE and myocarditis. Interestingly, SLE patients from areas(API >4) displayed higher levels of anti-Sm. Other auto antibodies levels were comparable among the two groups.

Conclusions The results of the present study revealed an association of malarial endemicity with differential production of autoantibodies, namely Sm. However, the role of malaria in the pathogenesis of SLE needs to be validated in a prospective study.