Mucocutaneous and visceral leishmaniasis in renal transplant patient from nonendemic region

Mahesh, E; Madhyastha, P Rakesh; Varma, Vijay; Gurudev, KC

doi:10.4103/1319-2442.190903

Cited by 6 publications

(14 citation statements)

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“…At the end of the process, we included 66 retrospective case reports and 4 retrospective case series. According to the modified Newcastle–Ottawa Scale, 11 items were classified as low-quality [ 7 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 ], 34 as average-quality [ 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 ], and 25 as high-quality studies [ 4 , 10 , 59 , 60 , 61 …”

Section: Resultsmentioning

confidence: 99%

“…Overall, European countries outside the Mediterranean basin recorded a small number of infections: Portugal ( n = 2) [ 24 , 66 ], Switzerland ( n = 1) [ 73 ], Finland ( n = 1) [ 60 ], United Kingdom ( n = 1) [ 19 ], and Belgium ( n = 1) [ 80 ]. Unexpectedly, a few cases were also described by authors living in countries in which Leishmania is considered as endemic, including India ( n = 5) [ 26 , 49 , 57 , 71 , 76 ], Sudan ( n = 1) [ 37 ], Nepal ( n = 1) [ 4 ], Kingdom of Saudi Arabia ( n = 2) [ 65 , 70 ], Iran ( n = 1) [ 50 ], and Colombia ( n = 1) [ 28 ]. Finally, Australia contributed with a single report [ 56 ].…”

Section: Resultsmentioning

confidence: 99%

“…Maintenance immunosuppression was very heterogeneous. Most patients were on a CNI-based triple-agent scheme with tacrolimus ( n = 54) [ 17 , 20 , 21 , 23 , 24 , 25 , 26 , 27 , 30 , 31 , 34 , 40 , 41 , 49 , 58 , 59 , 62 , 66 , 72 , 73 , 79 , 81 ] or cyclosporin ( n = 45) [ 4 , 17 , 29 , 30 , 33 , 35 , 36 , 39 , 40 , 45 , 46 , 47 , 50 , 51 , 53 , 54 , 60 , 61 , 63 , 64 , 65 , 69 , 70 , 71 , 74 , 75 , 78 , 79 ], AZA ( n = 51) […”

Section: Resultsmentioning

confidence: 99%

“…The most frequently reported form of Leishmaniasis was VL ( n = 149) [ 4 , 7 , 10 , 15 , 16 , 17 , 18 , 19 , 20 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 35 , 36 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 46 , 47 , 48 , 49 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 59 , 60 , 61 , 63 , 64 , 65 , 66 , 67 , 69 , 70 , 71 , 72 , 73 , ...…”

Section: Resultsmentioning

confidence: 99%

“…Fever, hepatomegaly, splenomegaly, and fatigue were the most represented symptoms, being reported in 123 [ 4 , 7 , 10 , 15 , 17 , 18 , 22 , 23 , 25 , 27 , 28 , 29 , 30 , 31 , 35 , 36 , 38 , 39 , 40 , 42 , 43 , 46 , 47 , 48 , 49 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 59 , 60 , 61 , 63 , 64 , 65 , 66 , 67 , 69 , 70 , 71 , 72 , 73 , 74 , 75 , 76 , 77 , 78 , 79 , ...…”

Section: Resultsmentioning

confidence: 99%

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Epidemiology, Clinical Characteristics, Diagnostic Work Up, and Treatment Options of Leishmania Infection in Kidney Transplant Recipients: A Systematic Review

Favi

Santolamazza²,

Botticelli³

et al. 2022

TropicalMed

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Current knowledge on Leishmania infection after kidney transplantation (KT) is limited. In order to offer a comprehensive guide for the management of post-transplant Leishmaniasis, we performed a systematic review following the latest PRISMA Checklist and using PubMed, Scopus, and Embase as databases. No time restrictions were applied, including all English-edited articles on Leishmaniasis in KT recipients. Selected items were assessed for methodological quality using a modified Newcastle–Ottawa Scale. Given the nature and quality of the studies (case reports and retrospective uncontrolled case series), data could not be meta-analyzed. A descriptive summary was therefore provided. Eventually, we selected 70 studies, describing a total of 159 cases of Leishmaniasis. Most of the patients were adult, male, and Caucasian. Furthermore, they were frequently living or travelling to endemic regions. The onset of the disease was variable, but more often in the late transplant course. The clinical features were basically similar to those reported in the general population. However, a generalized delay in diagnosis and treatment could be detected. Bone marrow aspiration was the preferred diagnostic modality. The main treatment options included pentavalent antimonial and liposomal amphotericin B, both showing mixed results. Overall, the outcomes appeared as concerning, with several patients dying or losing their transplant.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 3 more Smart Citations

Epidemiology, Clinical Characteristics, Diagnostic Work Up, and Treatment Options of Leishmania Infection in Kidney Transplant Recipients: A Systematic Review

Favi

Santolamazza²,

Botticelli³

et al. 2022

TropicalMed

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Leishmaniasis in Transplant Candidates and Recipients: Diagnosis and Management

Clemente¹,

Mourão²

2020

Emerging Transplant Infections

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Leishmaniasis is a rare disease in both solid-organ and hematopoietic stem cell transplantation. Additionally, the frequency of disease is likely related to the leishmaniasis prevalence in the general population. Although cutaneous leishmaniasis (CL) presentation is more prevalent than that of visceral leishmaniasis (VL) in the general population, the opposite occurs in transplant patients. The current available knowledge is based on small series, case reports, or extrapolations from studies conducted in the general population or in immunocompromised subjects. Therefore, recommendations for disease management are based on the opinion of experts. Leishmania transmission through organ grafts has not been conclusively demonstrated, and there are relatively low rates of transfusion-transmitted leishmaniasis (TTL). To date, compulsory screening for VL in organ donors and the deferral criteria have still not been established. In the context of transplant recipients, diagnosis and management remain a challenge. Delayed diagnosis frequently occurs because of low clinical suspicion and atypical disease presentation. Liposomal amphotericin is the drug of choice and the most commonly used therapy. However, patient profile, Leishmania species, disease extent, drug availability or toxicity, presence of concomitant infections, and especially response can influence this choice. Immunosuppression dose reduction is often recommended, but such decisions must be taken on an individual basis. The main challenges include donor screening and organ deferral, duration of therapy, secondary prophylaxis, and follow-up.

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Leishmaniasis in Transplant Candidates and Recipients: Diagnosis and Management

Clemente

Mourão

2021

Emerging Transplant Infections

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Mucocutaneous and visceral leishmaniasis in renal transplant patient from nonendemic region

Cited by 6 publications

References 1 publication

Epidemiology, Clinical Characteristics, Diagnostic Work Up, and Treatment Options of Leishmania Infection in Kidney Transplant Recipients: A Systematic Review

Epidemiology, Clinical Characteristics, Diagnostic Work Up, and Treatment Options of Leishmania Infection in Kidney Transplant Recipients: A Systematic Review

Leishmaniasis in Transplant Candidates and Recipients: Diagnosis and Management

Leishmaniasis in Transplant Candidates and Recipients: Diagnosis and Management

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