Serum erythropoietin concentration in anaemia of visceral leishmaniasis (kala‐azar) before and during antimonial therapy

Abstract

Summary. Serum erythropoietin (Epo) concentrations and variables of red cell and iron status were studied in 27 Sudanese patients who were treated with sodium stibogluconate for visceral leishmaniasis (kala-azar). Blood haemoglobin increased from 6·4 (Ϯ1·7 SD) to 9·5 (Ϯ1·4) g/dl during treatment. Serum ferritin decreased concomitantly. Serum iron levels were unchanged whereas the total iron binding capacity increased slightly. The pre-treatment serum Epo concentration in relation to the blood haemoglobin concentration was not as high as expected from the one in primary haematological diseases, indicating that there is a relative lack of Epo in anaemic kala-azar patients. Serum Epo further decreased during stibogluconate therapy. The normal dependence of the serum Epo level on the blood haemoglobin concentration was lost during mid-term antimonial treatment, but it recovered thereafter. Cell culture studies with the human hepatoma cells HepG2 showed that stibogluconate (у 30 mg/ ml) inhibited Epo gene expression. Thus, effective treatment of kala-azar with stibogluconate results in improvement of anaemia, although the drug itself may impair Epo production.

Evaluation of Nephroprotective and Immunomodulatory Activities of Antioxidants in Combination with Cisplatin against Murine Visceral Leishmaniasis

“…Regarding the hematological parameters, anemia is a frequent manifestation of visceral leishmaniasis that appear with the disease after an incubation period ranging from one month to several years [47] which is in accordance with our study where anemia was found in mice infected with L. donovani . Cisplatin treatment at both dosages brought about a significant reduction in the white blood cells and anemia.…”

Clinical Forms of Canine Visceral Leishmaniasis in Naturally Leishmania infantum–Infected Dogs and Related Myelogram and Hemogram Changes

“…In the current study, we documented that severe CVL is associated with a disorder in the erythroid bone marrow compartment, with significantly decreased red blood cell counts and hemoglobin and hematocrit values in symptomatic dogs, corroborating previous studies and elucidating the genesis of anemia in active CVL. It is possible that anemia could be related to factors such as formation of colonies impaired and increased hemolysis in enlarged spleen and liver associated with an inflammatory response to L. infantum infection [27]. In addition, a reduced plasma iron in the presence of greatly increased iron stores suggested that reticuloendothelial hyperplasia was accompanied by abnormal iron retention by macrophages typical of the anemia of chronic disorders.…”

Serum erythropoietin in heart failure patients treated with ACE‐inhibitors or AT1 antagonists

“…Anaemia is a side effect of many drugs [], some interfering at medullary red cell maturation and others inducing extracorpuscular, immunological damage to the red cells []. Finally drug‐induced anaemia may proceed through inhibition of Epo synthesis, as seen with sodium‐stibogluconate used to treat visceral leishmaniasis [].…”