Biochemical and nutritional evaluation of patients with visceral leishmaniasis before and after treatment with leishmanicidal drugs

Abstract

Revista da Sociedade Brasileira de Medicina Tropical 46(6):735-740, Nov-Dec, 2013http://dx.doi.org/10.1590/0037-8682-0198-2013 ABSTRACT Introduction: Visceral leishmaniasis (VL) is caused by the intracellular protozoan Leishmania donovani complex. VL may be asymptomatic or progressive and is characterized by fever, anemia, weight loss and the enlargement of the spleen and liver. The nutritional status of the patients with VL is a major determinant of the progression, severity and mortality of the disease, as it affects the clinical progression of the disease. Changes in lipoproteins and plasma proteins may have major impacts in the host during infection. Thus, our goal was evaluate the serum total cholesterol, high-density lipoprotein (HDL), low-density lipoprotein (LDL), triglycerides, glucose, albumin, globulin and total protein levels, as well as the body composition, of VL patients before and after treatment. Methods: Nutritional evaluation was performed using the bioelectrical impedance analysis (BIA) to assess body composition. Biochemical data on the serum total cholesterol, HDL, LDL, triglycerides, glucose, albumin, globulin and total protein were collected from the medical charts of the patients. Results: BIA indicated that both pre-treatment and post-treatment patients exhibited decreased phase angles compared to the controls, which is indicative of disease. Prior to treatment, the patients exhibited lower levels of total body water compared to the controls. Regarding the biochemical evaluation, patients with active VL exhibited lower levels of total cholesterol, HDL, LDL and albumin and higher triglyceride levels compared to patients after treatment and the controls. Treatment increased the levels of albumin and lipoproteins and decreased the triglyceride levels. Conclusions: Our results suggest that patients with active VL present biochemical and nutritional changes that are reversed by treatment. INTRODUCTION

<p>Alteration of Clinical Chemistry Parameters Among Visceral Leishmaniasis Patients in Western Tigrai, Ethiopia, 2018/2019: A Comparative Cross-Sectional Study</p>

“…6 Leishmania donovani causes lipid profile changes and affects the kidney which leads to alteration of glomerular and tubular functions. 4,9 In the present study, the mean of serum ALT, AST, and ALP was significantly higher in VL patients than healthy controls. This finding was in line with the previous study conducted in Sudan, Iraq, and India 6,8,12,13 which was reported a significantly higher value of AST, ALT, and ALP in VL patients.…”

“…7 Visceral leishmaniasis patients presented with enlarged liver and shows higher value of ALT, AST, ALP, 8 and the disease is also characterized by severe hypertriglyceridemia with reduced levels of total cholesterol, LDL-cholesterol, and HDL-cholesterol in adult patients. 9 Visceral leishmaniasis also affects the kidney and kidney involvement in chronic leishmaniasis is frequently associated with increased morbidity and mortality. Acute kidney injury was found in a significant proportion of VL patients.…”

Potential role of zinc in the visceromegaly regression and recovery of hematological parameters during treatment of visceral leishmaniasis in children from an endemic area

“…Similarly to the results obtained by Gatto et al . 23 , here we showed that serum albumin is slightly reduced during VL and the treatment of children, whether using amphotericin B or glucantime alone or in combination with Zn supplementation, increases serum albumin to normal levels ( Figure 1D ).…”

Predictors of relapse of visceral leishmaniasis in inner São Paulo State, Brazil

“…We believe that this finding is a proxy measure for malnourishment. It is worth noting that a previous study from our group, which included body measures, bioimpedance and biochemical assessment, found relevant evidence of malnourishment in VL patients, as compared to healthy controls (Gatto et al, 2013). Even though those measures could not be retrospectively assessed in the present analysis, it is tempting to infer that the worse the nutritional indicators, the greater the likelihood of relapse.…”