A comprehensive systematic review of leishmaniasis in patients undergoing drug-induced immunosuppression for the treatment of dermatological, rheumatological and gastroenterological diseases

Abstract

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Recurrent leishmaniasis infection isolated in the pleural fluid

“…It has been described that VL relapses in 15.1% of patients within 6 months of treatment though this number was investigated in the context of immunosuppressed individuals 12. It is likely that the degree of immunosuppression resulting from treatment with immunosuppressive agents for her underlying rheumatological disease would have contributed to initial disease compromise following infection 2. However, at the second presentation, our patient had been off immunosuppressive therapy for over 2 years, making recurrence due to immunosuppression very unlikely.…”

“…Immunosuppression remains a significant risk factor for infection of leishmaniasis. In the context of drug-induced immunosuppression, patients tend to be vulnerable to leishmaniasis infection after 5 years of immunosuppression 2. Poverty, poor housing and malnutrition are also risk factors for infection with cases most commonly seen in East Africa and South East Asia.…”

Unmet needs in the management of psoriasis in Latin America: a systematic review

“… 52 , 53 , 54 Literature also cites leishmaniasis, especially visceral cases, as a potential infectious complication of anti-TNF immunosuppression. 55 , 56 In the absence of specific guidelines, determining appropriate screening and therapeutic strategies can be challenging.…”

Imported leishmaniasis in travelers: a 7-year retrospective from a Parisian hospital in France

“…For VL occurring in non-endemic areas, the issue is to increase the suspicion index and confirm the diagnosis using qPCR [ 21 ]. Indeed, the clinical presentation is not specific and can be seen in different situations of immunosuppression such as HIV infection [ 22 ], anti-TNF treatment [ 23 , 24 ], after solid organ transplantation [ 25 ], or after hematopoietic stem cell transplantation [ 26 ]. Excepted for HIV co-infection in endemic areas [ 22 ], the prevalence of VL is often very low [ 23 , 24 ].…”

“…Indeed, the clinical presentation is not specific and can be seen in different situations of immunosuppression such as HIV infection [ 22 ], anti-TNF treatment [ 23 , 24 ], after solid organ transplantation [ 25 ], or after hematopoietic stem cell transplantation [ 26 ]. Excepted for HIV co-infection in endemic areas [ 22 ], the prevalence of VL is often very low [ 23 , 24 ]. The accepted physiopathology is the reactivation of a persistent parasite from a previous primo-infection subsequent to an acquired immunodeficiency [ 27 ].…”