Renal dysfunction in Leishmaniasis and Chagas disease coinfection: a case report

Alcântara, Cid Carlos Soares de; Santana, Laís Regina Lacerda; Evangelista, Priscila Dourado; Teixeira, André Costa; Silva, Geraldo Bezerra da; Daher, Elizabeth De Francesco

doi:10.1590/s1678-9946201860073

Cited by 5 publications

(4 citation statements)

References 9 publications

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“…Our finding revealed that the mean serum creatinine level which was found significant increase in VL patients compared to healthy controls is in corroboration with the previous studies conducted on renal function profile among VL cases, and reported AKI and progressive glomerulonephritis found an increase in serum creatinine level. 24–26 This may be attributed to the level of immune complex deposition, T cells and adhesion molecule activation during the inflammatory processes observed in active VL disease resulting in renal dysfunction. 27 , 28 The production of reactive oxygen species (ROSs) from the activated macrophage may also contribute to the alterations of renal function.…”

Section: Discussionmentioning

confidence: 99%

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Evaluation of Renal Function Profile in Human Visceral Leishmaniasis (Kala-Azar) Patients: A Case of Western Tigray, Ethiopia

Asfaw,

Gizaw,

Gnanasekaran

2023

RRTM

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Background Leishmaniasis is a vector-borne protozoan infection that has a wide clinical spectrum in the tropics and subtropics. Kidney damage is frequently associated with increased morbidity and mortality in visceral leishmaniasis ( VL ) patients. However, up to date, there is a very limited report on the effect of visceral leishmaniasis on kidney function profiling in Ethiopia. Objective To evaluate the renal function profile in human visceral leishmaniasis (kala-azar) patients. Materials and Methods Human blood was taken from VL patients (n = 100) and healthy controls (n = 100) attending Kahsay Abera and Mearg Hospitals, Western Tigray of Ethiopia. Serum was separated according to the conventional protocol and kidney function profiling (creatinine, urea, and uric acid) was analyzed by Mindray 200E automated chemistry analyzer. The estimated glomerular filtration rate (eGFR) was also assessed in this study. The obtained data were processed using SPSS Version 23.0. Descriptive statistics, independent-test, and bivariate correlations were used for data analysis. P values <0.05 were considered statistically significant at a 95% confidence level. Results The mean serum creatinine level was found significantly higher, while respective serum urea and eGFR were significantly lower in VL patients compared to healthy controls. Specifically, from 100 VL cases, an increased level of serum creatinine, urea, and uric acid was found in 10%, 9% and 15% VL cases, respectively; meanwhile, a decreased serum urea and eGFR have been reported from 33% to 44% VL cases, respectively. Conclusion The finding of this study asserted that visceral leishmaniasis causes derangement in kidney activities characterized by alteration of renal function profile. This may indicate that VL is the determinant factor for developing kidney dysfunction. This study encourages researchers to engage in visceral leishmaniasis and its effect on other organ function profiles in humans and identify potential markers for both prevention and intervention.

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Section: Discussionmentioning

confidence: 99%

“… 30 However, the present study is not incongruous with studies conducted by Efstratiadis et al and Alcântara et al, which reported a high level of serum urea for VL patients. 24 , 27 The difference may be attributed to the duration of dehydration (with an environmental difference), diet and severity of infection. 31…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Renal Function Profile in Human Visceral Leishmaniasis (Kala-Azar) Patients: A Case of Western Tigray, Ethiopia

Asfaw,

Gizaw,

Gnanasekaran

2023

RRTM

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“…L. mexicana causes cutaneous leishmaniasis (CL) and is endemic to Texas (Gustafson et al 1985, Barnes et al 1993, McHugh et al 1995, Wright et al 2008, Trainor et al 2010, but cross-reaction on Kalazar Detect Rapid Test with CL species is unlikely in both humans and dogs (Lemos et al 2008, Molinet et al 2013. Two additional dogs had positive rapid test results and were considered crossreaction with T. cruzi antibodies, but alternatively could be coinfected with T. cruzi and Leishmania spp., which have been found in dogs, humans, and wildlife (Alcântara et al 2018, de Oliveira Porfirio et al 2018, Viettri et al 2018.…”

Section: Posmentioning

confidence: 93%

Epidemiology of Vector-Borne Pathogens Among U.S. Government Working Dogs

Meyers

Auckland

Meyers

et al. 2021

Vector-Borne and Zoonotic Diseases

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Surveillance of U.S. domestic dogs for exposure to vector-borne pathogens can identify regions of transmission that are relevant for human and animal health. Working dogs with high levels of outdoor exposure may be sensitive indicators of local risk, owing to increased contact with vectors. We randomly selected 476 high-value government working dogs from 40 states to determine the prevalence of infection with Dirofilaria immitis and Rickettsia spp., and exposure to Ehrlichia spp., Anaplasma spp., and Borrelia burgdorferi, and identify risk factors for positivity. Additionally, we tested 100 of these dogs from Texas for Leishmania spp. where sand fly vectors occur. Previously published Trypanosoma cruzi infection data on these dogs were used to identify coinfection or co-exposures. Infection prevalence was 0.84% for D. immitis, and all dogs were negative for Rickettsia spp. DNA. Seroprevalence of each pathogen was: B. burgdorferi 0.84%, Ehrlichia spp. 1.3%, Anaplasma spp. 1.5%, Leishmania spp. 2.0%, and T. cruzi 12.2%. Coinfection or co-exposure took place in four (0.84%) dogs. In bivariable analysis, we found that D. immitis-positive and Ehrlichia-seropositive dogs were significantly older than negative dogs ( p < 0.05). Furthermore, seroprevalence of Anaplasma spp. was significantly higher among dogs in the Northeast United States relative to other areas of the country (4.7% vs. £ 1.4%; p = 0.041). Although autochthonous Leishmania infections have been described in the United States, the cases reported herein may represent imported Leishmania infection. Most federal working dogs are bred in Europe, where the parasite is endemic and congenitally transmitted. Serological cross-reaction between T. cruzi and Leishmania spp. complicates diagnosis. In this study, the use of multiple testing strategies in a comparative complementary manner provided evidence for these dogs' true exposures. Comprehensive surveillance for vector-borne pathogens in dogs can improve clinician awareness and target prevention and treatment in a One Health manner.

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“…The presence of viable Leishmania parasites in the urine of infected individuals is documented [120][121][122]. The crossing of the glomerular barrier by Leishmania is thought to be a consequence of VL renal lesions and renal failure [123,124]. Tubulointerstitial involvement and glomerulonephritis are the main causative agents of the proteinuria disorder, which is common in most patients with a clinical episode of leishmaniasis [125][126][127].…”

Section: Urinementioning

confidence: 99%

Noninvasive Biological Samples to Detect and Diagnose Infections due to Trypanosomatidae Parasites: A Systematic Review and Meta-Analysis

Sereno

Akhoundi

Sayehmri

et al. 2020

IJMS

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Unicellular eukaryotes of the Trypanosomatidae family include human and animal pathogens that belong to the Trypanosoma and Leishmania genera. Diagnosis of the diseases they cause requires the sampling of body fluids (e.g., blood, lymph, peritoneal fluid, cerebrospinal fluid) or organ biopsies (e.g., bone marrow, spleen), which are mostly obtained through invasive methods. Body fluids or appendages can be alternatives to these invasive biopsies but appropriateness remains poorly studied. To further address this question, we perform a systematic review on clues evidencing the presence of parasites, genetic material, antibodies, and antigens in body secretions, appendages, or the organs or proximal tissues that produce these materials. Paper selection was based on searches in PubMed, Web of Science, WorldWideScience, SciELO, Embase, and Google. The information of each selected article (n = 333) was classified into different sections and data were extracted from 77 papers. The presence of Trypanosomatidae parasites has been tracked in most of organs or proximal tissues that produce body secretions or appendages, in naturally or experimentally infected hosts. The meta-analysis highlights the paucity of studies on human African trypanosomiasis and an absence on animal trypanosomiasis. Among the collected data high heterogeneity in terms of the I 2 statistic (100%) is recorded. A high positivity is recorded for antibody and genetic material detection in urine of patients and dogs suffering leishmaniasis, and of antigens for leishmaniasis and Chagas disease. Data on conjunctival swabs can be analyzed with molecular methods solely for dogs suffering canine visceral leishmaniasis. Saliva and hair/bristles showed a pretty good positivity that support their potential to be used for leishmaniasis diagnosis. In conclusion, our study pinpoints significant gaps that need to be filled in order to properly address the interest of body secretion and hair or bristles for the diagnosis of infections caused by Leishmania and by other Trypanosomatidae parasites.

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Renal dysfunction in Leishmaniasis and Chagas disease coinfection: a case report

Cited by 5 publications

References 9 publications

Evaluation of Renal Function Profile in Human Visceral Leishmaniasis (Kala-Azar) Patients: A Case of Western Tigray, Ethiopia

Evaluation of Renal Function Profile in Human Visceral Leishmaniasis (Kala-Azar) Patients: A Case of Western Tigray, Ethiopia

Epidemiology of Vector-Borne Pathogens Among U.S. Government Working Dogs

Noninvasive Biological Samples to Detect and Diagnose Infections due to Trypanosomatidae Parasites: A Systematic Review and Meta-Analysis

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