Hormonal Disturbances in Visceral Leishmaniasis (Kala-Azar)

Verde, Frederico Araújo Lima; Verde, Francisco Agenor Araújo Lima; Neto, Augusto Saboia; Almeida, Paulo César de; Verde, Emir Mendonça Lima

doi:10.4269/ajtmh.2011.09-0171

Cited by 21 publications

(19 citation statements)

References 33 publications

(27 reference statements)

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“…Diagnosis and treatment of VL in renal transplant patients are also important because the course of VL can be complicated by variable degrees of graft dysfunction (17, 18, 33, 40–43). Acute leishmanial nephritis has been reported in the renal allograft of a Swiss patient 3 months after a well‐conducted treatment with L‐AmB (17).…”

Section: Literature Review and Discussionmentioning

confidence: 99%

Recurrent leishmaniasis in kidney transplant recipients: report of 2 cases and systematic review of the literature

Simon

Wissing

Marmol

et al. 2011

Transplant Infectious Dis

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The characteristics of 8 episodes of leishmaniasis with atypical manifestations in 2 Italian kidney transplant recipients are analyzed and contextualized among those of 52 other episodes of leishmaniasis observed in 19 transplant recipients found through a systematic review of the international literature. In all the patients, the initial episode was visceral leishmaniasis, which was associated with mucocutaneous involvement in 2 cases. With the exception of 1 case of post kala-azar dermal leishmaniasis, 2 episodes of Leishmania endophthalmitis, and 3 episodes of mucocutaneous leishmaniasis, all the recurrences were characterized by visceral involvement. The potential role of polymerase chain reaction in monitoring the infection, the importance of a long follow-up, the potential benefit of chemoprophylaxis, and the therapeutic challenges are discussed.

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Section: Literature Review and Discussionmentioning

confidence: 99%

Recurrent leishmaniasis in kidney transplant recipients: report of 2 cases and systematic review of the literature

Simon

Wissing

Marmol

et al. 2011

Transplant Infectious Dis

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“…They concluded that renal dysfunction could be an important feature of kala-azar and might be associated with increased morbidity and mortality. More recently, Agenor et al [ 5 ] reported proximal tubular damage in a cross-sectional study of 55 patients with visceral leishmaniasis. Increased albumin excretion was observed in 44% of patients, accounting for 17% of the total urinary protein excretion.…”

Section: Renal Disease In Leishmaniasismentioning

confidence: 99%

Renal involvement in leishmaniasis: a review of the literature

Clementi

Battaglia²,

Floris

et al. 2011

Clinical Kidney Journal

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Leishmaniasis, an infectious disease endemic in tropical, Asian and southern European countries, is caused by obligate intramacrophage protozoa and is transmitted through the bite of infected female sandflies. More than 20 leishmanial species are responsible for four main clinical syndromes: cutaneous leishmaniasis; mucocutaneous leishmaniasis; visceral leishmaniasis, also known as kala-azar, and post-kala-azar dermal leishmaniasis. Visceral leishmaniasis can present with varying clinical features and the kidney can also be involved. Both glomerular and tubular function can be altered and patients can develop proteinuria, haematuria, abnormalities in urinary concentration and acidification and acute and chronic renal insufficiency. Not only the disease itself but also the therapy administered might be responsible for the renal involvement in kala-azar. Indeed, some of the agents with efficiency against visceral leishmaniasis, such as pentavalent antimonial drugs, amphotericin B, pentamidine, miltefosine, paromomycin and simataquine, may be associated with a high risk of renal toxicity. In this article, the literature on renal involvement in visceral leishmaniasis is reviewed.

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“…Visceral Leishmaniasis (VL), also known as kala-azar, is a zoonosis caused by protozoan parasites from the genus Leishmania , which are typically found in tropical areas. The disease is endemic in many countries, including Brazil, which responds for 90% of cases in the Americas [ 1 ]. Due to its high incidence and the potential harms caused by the illness, it has become one of the World Health Organization’s (WHO) top priorities among neglected tropical diseases [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

Hyponatremia and risk factors for death in human visceral leishmaniasis: new insights from a cross-sectional study in Brazil

et al. 2017

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BackgroundVisceral leishmaniasis (VL) is an important and potentially fatal neglected tropical disease. The aim of this study was to investigate hyponatremia and risk factors for death among VL patients.MethodsThis is a cross-sectional study with VL patients admitted to a tertiary hospital in Northeast Brazil, from 2002 to 2009. Patients were divided into two groups: non-survivors and survivors. Hyponatremia was defined as serum sodium < 135 mEq/L. A logistic regression model was done to investigate risk factors for death.ResultsA total of 285 VL patients were included, with mean age 37 ± 15 years, and 74% were males. Thirty-four patients died (11.9%). Non-survivors had a significantly higher prevalence of dyspnea (38.2 vs. 16.7%, p = 0.003), pulmonary crackles (11.8 vs. 4.0%, p = 0.049), dehydration (23.5 vs. 10.8%, p = 0.033), oliguria (8.8 vs. 0.8%, p = 0.001) and jaundice (47.1 vs. 14.3%, p < 0.001). They also presented higher prevalence of hyponatremia (41.9 vs. 24.1%, p = 0.035), thrombocytopenia (91.2 vs. 65.3%, p = 0.002) and severe hypoalbuminemia (78.3 vs. 35.3%, p < 0.001). In multivariate analysis, moderate/severe hyponatremia (OR = 2.278, 95% CI = 1.046–4.962), thrombocytopenia (OR = 5.482, 95% CI = 1.629–18.443), jaundice (OR = 5.133, 95% CI = 1.793–14.696) and severe hypoalbuminemia (OR = 6.479, 95% CI = 2.124–19.766) were predictors of death.ConclusionHigher prevalence of dehydration, oliguria, pulmonary symptoms and liver involvement was found in non-survivors VL patients. Hypoalbuminemia and hyponatremia were frequent and significantly associated with mortality.

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Hormonal Disturbances in Visceral Leishmaniasis (Kala-Azar)

Cited by 21 publications

References 33 publications

Recurrent leishmaniasis in kidney transplant recipients: report of 2 cases and systematic review of the literature

Recurrent leishmaniasis in kidney transplant recipients: report of 2 cases and systematic review of the literature

Renal involvement in leishmaniasis: a review of the literature

Hyponatremia and risk factors for death in human visceral leishmaniasis: new insights from a cross-sectional study in Brazil

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