Causes and consequences of higher <i>Leishmania infantum</i> burden in patients with kala‐azar: a study of 625 patients

Zacarias, Danielle Alves; Rolão, Nuno; Pinho, Flaviane Alves de; Sene, Ingridi de Souza; Silva, Jailthon C; Pereira, Teresinha C.; Costa, Dorcas Lamounier; Costa, Carlos Henrique Nery

doi:10.1111/tmi.12877

Cited by 32 publications

(31 citation statements)

References 65 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In the same study, males ( n = 1,168) represented a greater number of deaths caused by VL compared to females ( n = 611), similar to other reports from Brazil as well as in Southern Iraq where L. donovani is endemic [84–86, 89, 90]. Furthermore, morbidity and mortality associated with HIV and Leishmania coinfection in Brazil and Spain are reported to be higher in males [84, 85, 87, 89, 91]. However, epidemiological studies cannot always discern whether differences between males and females are due to gender-related or biological factors.…”

Section: Visceral Leishmaniasissupporting

confidence: 79%

Sex-Related Differences in Immune Response and Symptomatic Manifestations to Infection with Leishmania Species

Lockard

Wilson

Rodríguez

2019

Journal of Immunology Research

View full text Add to dashboard Cite

Worldwide, an estimated 12 million people are infected with Leishmania spp. and an additional 350 million are at risk of infection. Leishmania are intracellular parasites that cause disease by suppressing macrophage microbicidal responses. Infection can remain asymptomatic or lead to a spectrum of diseases including cutaneous, mucocutaneous, and visceral leishmaniasis. Ultimately, the combination of both pathogen and host factors determines the outcome of infection. Leishmaniasis, as well as numerous other infectious diseases, exhibits sex-related differences that cannot be explained solely in terms of environmental exposure or healthcare access. Furthermore, transcriptomic evidence is revealing that biological sex is a variable impacting physiology, immune response, drug metabolism, and consequently, the progression of disease. Herein, we review the distribution, morbidity, and mortality among male and female leishmaniasis patients. Additionally, we discuss experimental findings and new avenues of research concerning sex-specific responses in cutaneous and visceral leishmaniasis. The limitations of current therapies and the emergence of drug-resistant parasites underscore the need for new treatments that could harness the host immune response. As such, understanding the mechanisms driving the differential immune response and disease outcome of males versus females is a necessary step in the development of safer and more effective treatments against leishmaniasis.

show abstract

Section: Visceral Leishmaniasissupporting

confidence: 79%

Sex-Related Differences in Immune Response and Symptomatic Manifestations to Infection with Leishmania Species

Lockard

Wilson

Rodríguez

2019

Journal of Immunology Research

View full text Add to dashboard Cite

show abstract

“…Hence, it is likely that malnourished people will have a greatly increased risk of developing VL. Indeed, in a study in Brazil, the parasite burden in children with severe and moderate malnutrition was almost three times higher than in nonmalnourished children [ 91 ].…”

Section: Resultsmentioning

confidence: 99%

New insights into leishmaniasis in the immunosuppressed

et al. 2018

View full text Add to dashboard Cite

Immunosuppression contributes significantly to the caseload of visceral leishmaniasis (VL). HIV coinfection, solid organ transplantation, malnutrition, and helminth infections are the most important immunosuppression-related factors. This review briefly describes the challenges of these associations. East Africa and the Indian subcontinent are the places where HIV imposes the highest burden in VL. In the highlands of Northern Ethiopia, migrant rural workers are at a greater risk of coinfection and malnutrition, while in India, HIV reduces the sustainability of a successful elimination programme. As shown from a longitudinal cohort in Madrid, VL is an additional threat to solid organ transplantation. The association with malnutrition is more complex since it can be both a cause and a consequence of VL. Different regimes for therapy and secondary prevention are discussed as well as the role of nutrients on the prophylaxis of VL in poverty-stricken endemic areas.

show abstract

“…Sometimes, an unnecessary splenectomy can be performed because of delayed diagnosis or misdiagnosis in patients with VL like as in our seventh patient (16). Sepsis, pneumonia, and jaundice are frequently concomitant with VL, especially in patients who have high parasitemia (17). Two patients had obvious cholestatic jaundice, and three patients had sepsis in our series.…”

Section: Discussionmentioning

confidence: 69%

Multiple Nodular Lesions in Spleen and Liver in Visceral Leishmaniasis

Kutlu

Herek

et al. 2019

Infect Dis Clin Microbiol

View full text Add to dashboard Cite

Objective:We aimed to describe the clinical, laboratory, and radiological characteristics of visceral leishmaniasis (VL) in our region to find additional clues that can help diagnosis. Materials and Methods:All the patients with VL who admitted to our clinic between January 2010 and January 2018 were reviewed retrospectively. The patients with symptoms and signs suggestive of VL and a positive indirect fluorescent antibody test (IFA) or rapid diagnostic test, and/or direct parasitology consisting of the presence of amastigotes of Leishmania in bone marrow aspirate were included in the study. We collected the demographic and clinical features, laboratory, and radiological information from the hospital database. Results:We present ten (seven males and three females) cases of VL, with the mean age of 53 (range of 31-75). Serological tests such as IFA or rapid diagnostic tests were positive in all patients. Amastigotes of Leishmania were present in only three of eight patients who underwent bone marrow biopsy. Abdominal magnetic resonance imaging or computed tomography revealed that all patients (10/10) had splenomegaly, eight of 10 patients had hepatomegaly, and seven patients had intraabdominal lymphadenopathy. Seven patients had multiple hypodense nodular lesions in the spleen with homogeneous parenchyma. Two patients had nodular lesions in the liver. Two patients died because of multiorgan failure before completing their treatment. The remaining patients completed liposomal amphotericin B treatment and cured.Conclusion: VL should be suspected in the diagnosis of the patients, who had long-term fever, splenomegaly, pancytopenia associated with multiple nodular lesions in the spleen with/without liver involvement.

show abstract

Causes and consequences of higher Leishmania infantum burden in patients with kala‐azar: a study of 625 patients

Cited by 32 publications

References 65 publications

Sex-Related Differences in Immune Response and Symptomatic Manifestations to Infection with Leishmania Species

Sex-Related Differences in Immune Response and Symptomatic Manifestations to Infection with Leishmania Species

New insights into leishmaniasis in the immunosuppressed

Multiple Nodular Lesions in Spleen and Liver in Visceral Leishmaniasis

Contact Info

Product

Resources

About