Congenitally transmitted visceral leishmaniasis: report of two Brazilian human cases

Mescouto-Borges, Myrlena Regina Machado; Maués, Érika; Costa, Dorcas Lamounier; Pranchevicius, Maria Cristina da Silva; Romero, Gustavo Adolfo Sierra

doi:10.1016/j.bjid.2012.10.017

Cited by 22 publications

(20 citation statements)

References 12 publications

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“…In our study, there were two cases of VL in pregnant patients who transmitted the disease congenitally to their infants 21 . The diagnosis of VL among pregnant women was parasitological due to the presence of Leishmania in the bone marrow aspirate.…”

Section: Discussionmentioning

confidence: 64%

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HIV/AIDS-related visceral leishmaniasis: a clinical and epidemiological description of visceral leishmaniasis in northern Brazil

Albuquerque

Mendonça

Cardoso

et al. 2014

Rev. Soc. Bras. Med. Trop.

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Section: Discussionmentioning

confidence: 64%

“…The diagnosis of VL among pregnant women was parasitological due to the presence of Leishmania in the bone marrow aspirate. PCR amplifi cation of parasite kDNA from newborn bone marrow samples suggested that the leishmaniasis was transmitted vertically because the newborns developed signs of the disease shortly after birth 21 .…”

Section: Discussionmentioning

confidence: 99%

HIV/AIDS-related visceral leishmaniasis: a clinical and epidemiological description of visceral leishmaniasis in northern Brazil

Albuquerque

Mendonça

Cardoso

et al. 2014

Rev. Soc. Bras. Med. Trop.

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“…First, we observed VL in mothers with adverse effects on pregnancy (gestational loss, preterm birth, low birthweight or infant VL). A total of 142 cases were identified in 16 reports . In 58 cases, the mother was not treated.…”

Section: Reported Impact Of Maternal Leishmaniasis On Infantsmentioning

confidence: 99%

T‐cell tolerance as a potential effect of congenital leishmaniasis on offspring immunity

Galindo-Sevilla

Mancilla-Ramı́rez

2018

Parasite Immunology

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Congenital transmission of leishmaniasis is recognized in cases detected by passive surveillance. Most cases are from low-resource countries, limiting the study of several important aspects of this route of infection, including the offspring's immune response. Studies on natural and experimentally infected animals suggest that parasites might be transmitted to the embryo or foetus at any time during pregnancy. As immune system undergoes sequential stages of development, an infection before the time of self-recognition could lead to central tolerance, making an individual specifically tolerant and susceptible to infection. In the alternative scenario, infection after self-recognition would allow the proper development of T-lymphocyte clones in response to Leishmania antigens, providing resistance to the disease. Newborns undergo a transient period of low expression of several immune surface molecules and a naïve adaptive immune response with no memory, which together might contribute to slow elimination of the parasite over several months. This insight is a proposed independent mechanism of the previously proven T-cell exhaustion and must be investigated. Analyses of infected placenta, cord blood and infant immunity are required for a better understanding of immunity in congenital leishmaniasis infection.

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“…All ages may be affected. There have been several cases in which infection became manifest during pregnancy resulting in congenital transmission 39 40…”

Section: Epidemiologymentioning

confidence: 99%

“…Nevertheless a positive PCR after treatment predicts development of PKDL or recurrence 73 75. It is also a sensitive indicator to diagnose congenital transmission 39. Loop-mediated isothermal amplification assay has excellent sensitivity and has been developed for use in low resource settings 76…”

Section: Diagnosismentioning

confidence: 99%

Visceral leishmaniasis: a forgotten epidemic

Zijlstra¹

2016

Arch Dis Child

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Visceral leishmaniasis (VL or kala-azar) is most endemic in Asia and Africa and commonly affects young children. It is usually caused by Leishmania donovani or Leishmania infantum that are transmitted by Phlebotomine sand flies. Transmission may be anthroponotic or zoonotic or both, depending on the endemic area. Clinical features include fever, hepatosplenomegaly, weight loss and pancytopenia. Younger age, malnutrition and immunosuppression (HIV infection, use of immunosuppressive drugs) are risk factors. Many infections remain asymptomatic. Diagnosis is made by demonstration of the Leishmania parasite in aspirates of lymph node, bone marrow or spleen. Serological tests such as rK39 strip test are widely used but the sensitivity varies. qPCR is useful to detect low numbers of parasites and to monitor treatment. Treatment is with AmBisome monotherapy in most areas but with drug combinations elsewhere. HIV co-infected patients are most difficult to treat and often relapse. Control efforts focus on case finding, availability of diagnostic tools, reservoir control and protection from sand flies (insecticides, bed nets). There is no human vaccine.

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Congenitally transmitted visceral leishmaniasis: report of two Brazilian human cases

Cited by 22 publications

References 12 publications

HIV/AIDS-related visceral leishmaniasis: a clinical and epidemiological description of visceral leishmaniasis in northern Brazil

HIV/AIDS-related visceral leishmaniasis: a clinical and epidemiological description of visceral leishmaniasis in northern Brazil

T‐cell tolerance as a potential effect of congenital leishmaniasis on offspring immunity

Visceral leishmaniasis: a forgotten epidemic

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