Rare association of Visceral leishmaniasis with Hodgkin's disease: A case report

Abstract

We present here a case of young male with complaints of fever and swelling in the neck for eight months. History of progressive weakness associated with weight loss was present. Physical examination revealed pallor, multiple enlarged cervical lymph nodes and hepatosplenomegaly. Investigations showed pancytopenia, hyperglobinemia and Leishman-Donovan bodies on bone marrow aspiration. Serological test confirmed diagnosis of visceral leishmaniasis. However, cervical lymph node aspiration and biopsy were suggestive of Mixed cellularity Hodgkin's disease. This made it a very rare case of Leishmaniasis as an opportunistic infection in a patient of pre-chemotherapy Hodgkin's disease. There was marked improvement in haematological profile and regression of hepatosplenomegaly with Amphotericin B treatment followed by favourable response to chemotherapy. The case emphasizes the suspicion for leishmaniasis as a masquerader and as an opportunistic infection in haematological malignancies.

The Potential Role of Nrf2 Signaling in Leishmania Infection Outcomes

“…The dysregulation of Keap1/Nrf2 signaling promotes the dual roles of Nrf2 in cancer, being considered a tumor suppressor and a target oncogene (Menegon et al, 2016). There is rare case associations of leishmaniasis with cancer-related disorder, but nothing yet associated with Nrf2 regulation (Kopterides et al, 2007;Kumar et al, 2011). Activation of Nrf2 is also related to the recruitment and infiltration of neutrophil natural killer (NK) and monocyte cells at the site of inflammation, and this process is mediated by Interleukin (IL)-17D, a target of Nrf2 (Seelige et al, 2018).…”

Clonality testing in the lymph nodes from dogs with lymphadenomegaly due to Leishmania infantum infection

“…Leishmaniosis has been described in association with and as potential inducer of lymphoma in human medicine (11) and there is some evidence that this could also occur in dogs [65]. The underlying mechanisms are thought to originate in an adverse effect of the Leishmania on macrophages and dendritic cells which enables malignant cells to remain unnoticed from immune destruction on the one hand and impaired adaptive immune responses blocking the activation of naive and effector T cells on the other [70,71]. Therefore, it would be interesting to retrieve long-term follow up of the patients involved in this study for hypothetical lymphoma development.…”

Hodgkin’s lymphoma with multifocal Staphylococcus aureus infection in a 29-year-old male — a case study

“…Immunity disorders typical for HL are associated with decreased capacity of lymphoid dendritic cells (plasmacytoid dendritic cells -s-pDCs) to produce interferon-a (IFN-a) and a reduced number of circulating CD4 + T cells [16]. These disorders mainly cause weakness of cellular immunity and contribute to systemic, opportunistic viral, fungal, protozoan, or tuberculous infections [16][17][18][19][20][21][22]. The spectrum of infections occurring in patients with HL is similar to other immune disorders such as acquired immunodeficiency syndrome (AIDS), glucocorticoid therapy, severe combined immunodeficiency syndrome (SCID), or Di George syndrome [16].…”

“…Bone infections with other aetiologies are also described. In presented cases of bone and marrow infections (osteomyelitis), the infection was caused by bloodstream, usually due to a wound or soft tissue damage [22][23][24].…”