Visceral leishmaniasis in pregnant women from Rio Grande do Norte, Brazil: A case report and literature review

Cunha, Francielly Tertulino; Lopes, Isadora C.; Oliveira, Francisco Clitson Sousa; Queiroz, Igor Thiago

doi:10.1590/0037-8682-0233-2018

Cited by 8 publications

(8 citation statements)

References 7 publications

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“…Furthermore, the good response to amphotericin B (primarily deoxycholate and later liposomal) supports this conclusion. 3 It is therefore reasonable to infer an association between VL and consumption coagulopathy.…”

Section: Discussionmentioning

confidence: 99%

Rare association of consumptive coagulopathy in visceral leishmaniasis: A case report

et al. 2020

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Visceral leishmaniasis is a tropical parasitic disease caused by the species of the genus Leishmania infantum. The clinical picture includes fever, splenomegaly, leucopenia, anaemia and hypergammaglobulinaemia. There may also be a drop in plasma fibrinogen levels or an increase in plasma fibrinolytic activity. Furthermore, visceral leishmaniasis may be the trigger for secondary haemophagocytic lymphohistiocytosis. On the other hand, disseminated intravascular coagulation may also result. The International Society of Thrombosis and Hemostasis has recommended the use of a scoring system for disseminated intravascular coagulation. An association between visceral leishmaniasis and consumption coagulopathy is not frequent. Our systematic literature review from 1967 to 2019 pointed to the report of only 16 cases. Our case demonstrates that it is necessary to be aware of the existence of this association.

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Section: Discussionmentioning

confidence: 99%

Rare association of consumptive coagulopathy in visceral leishmaniasis: A case report

et al. 2020

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“…Pancytopenia associated with leishmaniasis may be commonly observed in endemic regions. [1617] However, the relatively high share of pancytopenia cases due to leishmaniasis is more remarkable because Uttarakhand region is a non-endemic region for this parasitic infection. [181920] Recent previous reports have suggested that there is a focus of leishmaniasis at high altitude in Garhwal region of Uttarakhand[2122] and the present findings support this contention.…”

Section: Discussionmentioning

confidence: 99%

Clinico-hematological study of pancytopenia: A single-center experience from north Himalayan region of India

Chandra

Gupta

Nath

et al. 2019

J Family Med Prim Care

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Background:Pancytopenia, an important hematological presentation is associated with different causes, which may vary in different regions. Uttarakhand, a north Himalayan state of India lacks studies of pancytopenia and the prevalent causes present in this region. Therefore, the present study was conducted to study the clinico-hematological profile of pancytopenia in a tertiary care center in the Uttarakhand, a north Himalayan state of India. It was also intended to study if these causes showed any variation from other studies done in different regions of India.Materials and Methods:The present observational study was conducted in a tertiary care institute situated in Uttarakhand state of India over a period of 1 year and 8 month from June 2017 to Feb 2019 including all the cases of pancytopenia.Results:The most common cause of pancytopenia was megaloblastic anemia (25%), followed by aleukemic leukemia and hypoplastic/aplastic anemia (19.1% each). Visceral leishmaniasis also constituted an important cause of pancytopenia in this study (11.7%).Conclusion:The study concludes that megaloblastic anemia and aleukemic leukemia are the most common cause of pancytopenia. Although leishmaniasis is considered to be non-endemic in this region, it constitutes an important cause of pancytopenia here. The clinicians, especially the physicians practicing the primary care and pathologists, should be aware of the different causes of pancytopenia present in this Himalayan region of India; therefore, delay in diagnosis can be prevented along with unnecessary investigations.

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“…During pregnancy, larger CL lesions with a highly exophytic appearance are more typical 3,15 . Additionally, vertical transmission from mother to infant may occur either transplacentally in utero or during labor 16,17 . Animal models have demonstrated that vertical transmission can occur in both VL and CL/MCL 18 .…”

Section: Introductionmentioning

confidence: 99%

Dosing implications for liposomal amphotericin B in pregnancy

et al. 2023

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Liposomal amphotericin B (LAmB) is used in the treatment of opportunistic fungal and parasitic infections, including leishmaniasis. Given its lack of known teratogenicity in pregnancy, LAmB is a preferred agent for treatment for these patients. However, significant gaps remain in determining optimal dosing regimens for LAmB in pregnancy. We describe the use of LAmB for a pregnant patient with mucocutaneous leishmaniasis (MCL) using a dosing strategy of 5 mg/kg/day for days 1–7 using ideal body weight followed by 4 mg/kg weekly using adjusted body weight. We reviewed the literature for LAmB dosing strategies, particularly dosing weight, in pregnancy. Of the 143 cases identified in 17 studies, only one reported a dosing weight, in which ideal body weight was used. Five Infectious Diseases Society of America guidelines in total discussed the use of amphotericin B in pregnancy but no guidelines included recommendations for dosing weight. This review describes our experience in using ideal body weight for dosing LAmB in pregnancy for the treatment of MCL. Use of ideal body weight may minimize risk of adverse effects to the fetus compared to the use of total body weight while maintaining efficacy for treatment of MCL in pregnancy.

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Visceral leishmaniasis in pregnant women from Rio Grande do Norte, Brazil: A case report and literature review

Cited by 8 publications

References 7 publications

Rare association of consumptive coagulopathy in visceral leishmaniasis: A case report

Rare association of consumptive coagulopathy in visceral leishmaniasis: A case report

Clinico-hematological study of pancytopenia: A single-center experience from north Himalayan region of India

Dosing implications for liposomal amphotericin B in pregnancy

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