Changing Epidemiology: A New Focus of Kala-azar at High-Altitude Garhwal Region of North India: Table 1.

Bhat, Nowneet Kumar; Ahuja, Vivek; Dhar, Minakshi; Ahmad, Sohaib; Pandita, Neerul; Gupta, Vibha; Chandra, Smita

doi:10.1093/tropej/fmw056

Cited by 9 publications

(7 citation statements)

References 12 publications

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“…A decrease in the number or function of CD4 cells may cause recurrence, as in the case of patients receiving corticosteroids or chemotherapy, in transplant recipients, or in association with infection with HIV; in this scenario, a new therapeutic regimen may be required 49 – 51 .…”

Section: Visceral Leishmaniasis or Kala-azar (Black Fever)mentioning

confidence: 99%

Leishmaniasis: a review

Quintanilla-Cedillo¹,

2017

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Leishmaniasis is caused by an intracellular parasite transmitted to humans by the bite of a sand fly. It is endemic in Asia, Africa, the Americas, and the Mediterranean region. Worldwide, 1.5 to 2 million new cases occur each year, 350 million are at risk of acquiring the disease, and leishmaniasis causes 70,000 deaths per year. Clinical features depend on the species of Leishmania involved and the immune response of the host. Manifestations range from the localized cutaneous to the visceral form with potentially fatal outcomes. Many drugs are used in its treatment, but the only effective treatment is achieved with current pentavalent antimonials.

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Section: Visceral Leishmaniasis or Kala-azar (Black Fever)mentioning

confidence: 99%

Leishmaniasis: a review

Quintanilla-Cedillo¹,

2017

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“…Sporadic VL cases have been reported from Kerala, Morena, and Malwa regions of Madhya Pradesh and Haryana [ 12 , 51 – 54 ]. Case reports of the disease from sub-Himalayan parts, including Uttarakhand, Himachal Pradesh, Jammu, and Kashmir, are of special interest because VL is typically a disease of low altitude [ 14 , 15 , 55 – 57 ]. In fact, leishmaniasis is reported as the most common cause of bone marrow infections in the North Himalayan region [ 58 ].…”

Section: Indian Subcontinentmentioning

confidence: 99%

Atypical leishmaniasis: A global perspective with emphasis on the Indian subcontinent

et al. 2018

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BackgroundAmong the neglected tropical diseases, leishmaniasis continues to be prevalent in many tropical and subtropical countries despite international, national, and local efforts towards its control and elimination over the last decade. This warrants a critical evaluation of such factors as under-reporting, asymptomatic infections, post kala azar dermal leishmaniasis (PKDL) cases, and drug resistance. In this review, we highlight lesser-understood atypical presentations of the disease involving atypical parasite strains against a background of classical leishmaniasis with a focus on the Indian subcontinent.Methods and findingsA literature review based on endemic areas, the nature of disease manifestation, and underlying causative parasite was performed with data collected from WHO reports for each country. Searches on PubMed included the term ‘‘leishmaniasis” and “leishmaniasis epidemiology” alone and in combination with each of the endemic countries, Leishmania species, cutaneous, visceral, endemic, non-endemic, typical, classical, atypical, and unusual with no date limit and published in English up to September 2017. Our findings portray a scenario with a wider distribution of the disease in new endemic foci, with new discoveries of parasite-driven atypical disease manifestations in different regions of the world. Unlike the classical picture, some Leishmania species are associated with more than one disease presentation, e.g., the L. donovani complex, generally associated with the visceral form, is now also associated with a cutaneous disease presentation, while L. tropica species complex, known to cause cutaneous disease, can cause viscerotropic disease. This phenomenon points towards the discovery of novel parasite variants as etiologic agents of atypical disease manifestations and represents an excellent opportunity to identify and study genes that control disease virulence and tropism.ConclusionsThe increased recognition of atypical leishmaniasis as an outcome of parasite variants has major implications for leishmaniasis control and elimination. Identifying molecular correlates of parasite isolates from distinct regions associated with different disease phenotypes is required to understand the current epidemiology of leishmaniasis in regions with atypical disease.

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“…Enlargement of the liver (hepatomegaly) is a common symptom in VL patients; 30-100% of VL patients with parasitological confirmation present with liver enlargement [2][3][4][5][6][7][8][9][10][11]. In addition, biochemical markers of hepatocellular damage, AST and ALT, are found to be elevated in the blood of these patients [2,[9][10][11][12]. Moreover, it has been reported that liver failure may be a direct cause of death in VL patients [13].…”

Section: Introductionmentioning

confidence: 99%

Hepatomegaly Associated with Non-Obstructive Sinusoidal Dilation in Experimental Visceral Leishmaniasis

et al. 2021

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Visceral leishmaniasis (VL) is the most severe form of leishmaniasis caused by protozoan parasites of the genus Leishmania. Hepatomegaly is one of the most frequent clinical manifestations of VL, whereas immunopathology of the symptom has not been well investigated. Using our chronic model of experimental VL, we examined the influence of Leishmania donovani infection on the liver by clinical, histological, and biochemical analyses. The infected mice showed increased liver weight 24 weeks post-infection. Although an increase in serum ALT and inflammatory cell accumulation were observed in the livers of infected mice, no apparent parenchymal necrosis or fibrosis was observed. Tissue water content analyses demonstrated that increased liver weight was predominantly due to an increase in water weight. Together with the finding of hepatic sinusoidal dilation, these results suggested that edema associated with sinusoidal dilation causes hepatomegaly in L. donovani infection. Immunostaining of platelets and erythrocytes showed no thrombus formation or damage to the sinusoidal endothelium in the liver of infected mice. Taken together, these results suggest that hepatomegaly during experimental VL is caused by non-obstructive sinusoidal dilation.

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Changing Epidemiology: A New Focus of Kala-azar at High-Altitude Garhwal Region of North India: Table 1.

Cited by 9 publications

References 12 publications

Leishmaniasis: a review

Leishmaniasis: a review

Atypical leishmaniasis: A global perspective with emphasis on the Indian subcontinent

Hepatomegaly Associated with Non-Obstructive Sinusoidal Dilation in Experimental Visceral Leishmaniasis

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