Visceral leishmaniasis reactivation in transplant patients: a minireview with report of a new case

Postorino, Maria Concetta; Bellantoni, Marianna; Catalano, Concetta; Caridi, Graziella; Rosa, Marta De; Seck, Sidy Mohamed; Enia, Giuseppe

doi:10.5301/jn.2011.8343

Cited by 25 publications

(21 citation statements)

References 10 publications

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“…Zira immün süpresyon, intraselüler mikroorganizmalara karşı savunma mekanizmalarını, T hücre aktivasyonunu ve proliferasyonunu değiştirir. Son 20 yılda organ transplantasyonu uygulamalarındaki artışa paralel olarak viseral leyiş-manyoz olgularının da arttığı ifade edilmektedir 11,12 . Transplantlı hastalarda viseral leyiş-manyoz primer enfeksiyon şeklinde olabileceği gibi immün süpresif tedaviyle sessiz enfeksiyonun reaktivasyonu sonucunda da gelişebilir 12 .…”

Section: Discussionunclassified

“…Son 20 yılda organ transplantasyonu uygulamalarındaki artışa paralel olarak viseral leyiş-manyoz olgularının da arttığı ifade edilmektedir 11,12 . Transplantlı hastalarda viseral leyiş-manyoz primer enfeksiyon şeklinde olabileceği gibi immün süpresif tedaviyle sessiz enfeksiyonun reaktivasyonu sonucunda da gelişebilir 12 . Viseral leyişmanyoz, solid organ transplantasyonlu hastaların %22-37.5'inde tedavinin ilk yılında sıklıkla tekrarlamaktadır 13 .…”

Section: Discussionunclassified

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Evaluation of Fourteen Adult Cases with Visceral Leishmaniasis

Kurşun¹,

Turunç²,

Demıroğlu³

et al. 2013

Mikrobiyol Bul

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ÖZETViseral leyişmanyoz ülkemizin de içinde bulunduğu Akdeniz ülkelerinde yaygın olarak görülen, tatarcık sineği (Phlebotomus) tarafından taşınan Leishmania protozoonunun neden olduğu hayatı tehdit eden sistemik bir enfeksiyon hastalığıdır. Bu çalışmada, Ocak 2005-Nisan 2012 tarihleri arasında kliniğimizde izlenen viseral leyişmanyoz olgularının retrospektif olarak irdelenmesi ve literatür ile karşılaştırılması amaç-lanmıştır. Çalışmaya, viseral leyişmanyoz tanısıyla izlenen ve tedavi süreleri tamamlandıktan sonra bir yıl boyunca takip edilen 14 olgu (7 kadın, 7 erkek; yaş aralığı: 19-64 yıl, yaş ortalaması: 41.6 ± 12.9 yıl) alın-mış ve olgulara ait bilgiler hasta dosyalarından elde edilmiştir. Olguların 10'u immünokompetan, dördü immünosüpresif olup, altısı Adana'da sekizi ise güney ve güneydoğu Anadolu bölgesinin farklı illerinde ikamet etmektedir. Olgularda, belirtilerin başlangıcından tanı konuluncaya kadar geçen süre ortalama 75 (aralık: 2-272) gün olup, olguların %79 (11/14)'u daha önce bir sağlık kuruluşuna başvurmuş ve antibiyotik tedavisi almıştır. Olguların en çok ateş yüksekliği (%100), üşüme/titreme (%93), halsizlik (%71) ve kilo kaybı (%57) yakınmaları ile başvurdukları tespit edilmiştir. Fizik muayene bulguları irdelendiğinde; 8 (%57) olguda ateş, 11 (%79) olguda splenomegali ve 7 (%50) olguda hepatosplenomegali saptanmıştır. Olguların laboratuvar verileri değerlendirildiğinde; tümünde (%100) hipoalbünemi ve 10 (%71)'unda pansitopeni tespit edilmiştir. Viseral leyişmanyoz tanısı; 12 (%86) olguda kemik iliği aspirasyonu ve iki olguda doku (karaciğer/dalak) biyopsi örneklerinin yayma preparatında parazitin amastigot formunun gö-rülmesiyle konulmuştur. Tüm hastalardan alınan kemik iliği örneklerinin NNN (Novy-MacNeal-Nicole) be- Geliş Tarihi

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Section: Discussionunclassified

Evaluation of Fourteen Adult Cases with Visceral Leishmaniasis

Kurşun¹,

Turunç²,

Demıroğlu³

et al. 2013

Mikrobiyol Bul

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“…VL can occur after primary infection through a sandfly bite, via transplanted organs, blood products or reactivation of latent infections. Although more than 100 VL case reports have been described and reviewed in the literature [1][2][3][4][5], there is a lack of information regarding risk factors, the role of immunosuppression and disease outcome across different types of transplantation. The recognition and management of VL remains challenging even in transplant recipients from endemic regions [6][7][8][9][10][11].…”

Section: Introductionmentioning

confidence: 96%

Risk factors, clinical features and outcomes of visceral leishmaniasis in solid-organ transplant recipients: a retrospective multicenter case–control study

Clemente

Vidal

Girão

et al. 2015

Clinical Microbiology and Infection

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Visceral leishmaniasis (VL) is a rare disease in solid-organ transplant (SOT) recipients. Therefore, little is known about the risk factors and disease behavior in the transplant setting. This multicenter, matched case-control study (1:2 ratio) was designed to determine the risk factors, clinical features and outcomes of VL among this population. Control and case subjects were matched by center, transplant type and timing. Thirty-six VL cases were identified among 25 139 SOT recipients (0.1%). VL occurred 5.7-fold more frequently in Brazil than in Spain, presenting a median time of 11 months after transplantation. High-dose prednisone in the preceding 6 months was associated with VL. Patients were diagnosed over 1 month after symptom onset in 25% of cases. Thirty-one patients (86%) were febrile upon diagnosis, 81% exhibited visceromegaly and 47% showed pancytopenia. Concomitant infection was common. Parasites were identified in 89% of patients; the remaining patients were diagnosed by serology. The majority of the patients received amphotericin B. Relapses occurred in 25.7% of cases, and the crude mortality rate was 2.8%. VL after SOT is related to the VL prevalence in the general population. Delayed diagnosis frequently occurs. Liposomal amphotericin is the most commonly used therapy; mortality is low, although relapses are common. Clinical Microbiology and Infection

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“…The excretion of amphotericin B, pentamidine isethionate and miltefosine in breast milk is [93][94][95][96][97][98]103,[107][108][109][110][111][112][113][114] (Table 3).…”

Section: Resultsmentioning

confidence: 99%

“…In transplant recipients, CL and ML are rare and usually there is a time interval between transplantation and disease manifestation 106 . Reviews of organ transplant recipients with leishmaniasis show that the majority of patients have undergone renal transplantation, and most cases are identifi ed as visceral-type disease 93,[107][108][109] .…”

Section: Human Immunodefi Ciency Virus/acquired Immunodefi Ciencymentioning

confidence: 99%

Treatment of American tegumentary leishmaniasis in special populations: a summary of evidence

Silva

Galvão

Gomes

et al. 2013

Rev. Soc. Bras. Med. Trop.

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Revista da Sociedade Brasileira de Medicina Tropical 46(6):669-677, Nov-Dec, 2013http://dx.doi. org/10.1590/0037-8682-0104-2013 Address to: Dr a Juliana Saboia Fontenele e Silva. Lab. ABSTRACT We aimed to assess and synthesize the information available in the literature regarding the treatment of American tegumentary leishmaniasis in special populations. We searched MEDLINE (via PubMed), EMBASE, LILACS, SciELO, Scopus, Cochrane Library and mRCT databases to identify clinical trials and observational studies that assessed the pharmacological treatment of the following groups of patients: pregnant women, nursing mothers, children, the elderly, individuals with chronic diseases and individuals with suppressed immune systems. The quality of evidence was assessed using the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) approach. The available evidence suggests that the treatments of choice for each population or disease entity are as follows: nursing mothers and children (meglumine antimoniate or pentamidine), patients with renal disease (amphotericin B or miltefosine), patients with heart disease (amphotericin B, miltefosine or pentamidine), immunosuppressed patients (liposomal amphotericin), the elderly (meglumine antimoniate), pregnant women (amphotericin B) and patients with liver disease (no evidence available). The quality of evidence is low or very low for all groups. Accurate controlled studies are required to fi ll in the gaps in evidence for treatment in special populations. Post-marketing surveillance programs could also collect relevant information to guide treatment decision-making.

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Visceral leishmaniasis reactivation in transplant patients: a minireview with report of a new case

Cited by 25 publications

References 10 publications

Evaluation of Fourteen Adult Cases with Visceral Leishmaniasis

Evaluation of Fourteen Adult Cases with Visceral Leishmaniasis

Risk factors, clinical features and outcomes of visceral leishmaniasis in solid-organ transplant recipients: a retrospective multicenter case–control study

Treatment of American tegumentary leishmaniasis in special populations: a summary of evidence

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