Current clinical, laboratory, and treatment outcome characteristics of visceral leishmaniasis: results from a seven-year retrospective study in Greece

Georgiadou, Sarah P.; Stefos, Aggelos; Spanakos, Gregory; Skrimpas, Stergios; Makaritsis, Konstantinos; Sipsas, Nikolaos V.; Dalekos, George Ν.

doi:10.1016/j.ijid.2015.02.021

Cited by 33 publications

(31 citation statements)

References 43 publications

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“…Fever in VL is almost always present , splenomegaly in 23.7% to 100% of patients , elevated liver enzymes in 42–85% of cases , increased levels of LDH and CRP are seen in 72.5% and 83.1% of cases . In the patient presented here, CRP was elevated from the first day of presentation and remained unchanged until initiation of therapy, LDH started rising with the appearance of pancytopenia.…”

Section: Discussionmentioning

confidence: 59%

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Visceral leishmaniasis in a patient with diabetes mellitus type 2 and discrete bicytopenia

Schwetz

Trummer

Friedl

et al. 2017

Clinical Case Reports

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Section: Discussionmentioning

confidence: 59%

“…Weeks to months after a trip to endemic regions, fever, loss of appetite, weight loss, lymphadenopathy may occur, often accompanied by pancytopenia, hepatosplenomegaly, and elevated liver enzymes . The infection may mimic leukemia, viral infections, or autoimmune diseases.…”

Section: Introductionmentioning

confidence: 99%

Visceral leishmaniasis in a patient with diabetes mellitus type 2 and discrete bicytopenia

Schwetz

Trummer

Friedl

et al. 2017

Clinical Case Reports

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“…The World Health Organization recommends L‐AmB as the first choice for VL caused by Leishmania infantum due to the shorter duration of drug therapy and lower toxicity compared with conventional amphotericin B and MA . Although studies have indicated the efficacy and safety of L‐AmB therapy, its use is still limited due to its high cost …”

Section: Case Descriptionmentioning

confidence: 99%

Adverse reactions to meglumine antimoniate in Brazilian inpatients with visceral leishmaniases: A case series

et al. 2019

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Leishmaniasis is a group of neglected diseases with complex clinical manifestations and is caused by the protozoa Leishmania infantum in Latin America. Leishmaniasis is a poverty-related disease that is endemic in 65 countries. Visceral leishmaniasis (VL) is the most severe clinical form of leishmaniasis. Brazil is among seven countries that account for 90% of the global cases of VL, which is considered a public health problem due to its wide geographic distribution and high lethality rates. 1,2 These data reflect the magnitude of VL in this region and the need for health surveillance programmes focusing on early diagnosis and the efficacy and safety of drug therapy.HIV (human immunodeficiency virus) coinfection has increased the number of deaths related to VL. 3 Therapeutic options for VL include pentavalent antimony (Sb v ) salts, several formulations of amphotericin B, paromomycin, pentamidine and the oral agent miltefosine. However, these options exhibit variable efficacy and have significant severe adverse drug reactions (ADR) or high costs, such as that for liposomal amphotericin B (L-AmB). 4,5 In Brazil, meglumine antimoniate (MA) is the first-choice drug for VL, despite its high toxicity. 6 Patients taking MA may experience ADR due to the cumulative drug effects. These ADR include important alterations in cardiac, hepatic and renal functions and pancreatitis. In most cases, these ADR are transient and resolve well when recognized and managed at an early stage. These ADR may require temporary suspension, dose adjustment or drug replacement. 7 Such reactions may be severe and can affect patients' quality of life. 8 We report a case series of ADR in hospitalized VL patients treated with MA. | C A S E DE SCRIP TI ONThis is a case series studied at a general hospital in Belo Horizonte, Southeast Brazil. We studied 14 patients with a mean age of Abstract What is known and objectives: Adverse drug reactions (ADR) related to the treatment of visceral leishmaniasis (VL) can cause severe clinical complications. We report a case series of ADR in hospitalized VL patients on meglumine antimoniate (MA). Case description:Seven cases of patients taking MA had at least one objective evidence for suspected ADR, including electrocardiographic, laboratory or clinical alteration.

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“…High doses are needed to achieve a cure, and irreversible diabetes has been reported in 4%-12% of cases. 44 The primary action of pentamidine against Leishmania is not clearly understood, but the drug's structural characteristics and experimental results suggest that the active transport system and the mitochondria are the final sites of inhibition. A series of experiments showed that it acts as an inhibitor of polyamine uptake and the arginine transporter, 45 while other findings indicate the mitochondrial replication system as possible target (through inhibition of topoisomerase II activity).…”

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confidence: 99%

Nanostructured delivery systems with improved leishmanicidal activity: a critical review

Bruni¹,

Stella²,

Giraudo³

et al. 2017

IJN

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Leishmaniasis is a vector-borne zoonotic disease caused by protozoan parasites of the genus Leishmania , which are responsible for numerous clinical manifestations, such as cutaneous, visceral, and mucocutaneous leishmaniasis, depending on the site of infection for particular species. These complexities threaten 350 million people in 98 countries worldwide. Amastigotes living within macrophage phagolysosomes are the principal target of antileishmanial treatment, but these are not an easy target as drugs must overcome major structural barriers. Furthermore, limitations on current therapy are related to efficacy, toxicity, and cost, as well as the length of treatment, which can increase parasitic resistance. Nanotechnology has emerged as an attractive alternative as conventional drugs delivered by nanosized carriers have improved bioavailability and reduced toxicity, together with other characteristics that help to relieve the burden of this disease. The significance of using colloidal carriers loaded with active agents derives from the physiological uptake route of intravenous administered nanosystems (the phagocyte system). Nanosystems are thus able to promote a high drug concentration in intracellular mononuclear phagocyte system (MPS)-infected cells. Moreover, the versatility of nanometric drug delivery systems for the deliberate transport of a range of molecules plays a pivotal role in the design of therapeutic strategies against leishmaniasis. This review discusses studies on nanocarriers that have greatly contributed to improving the efficacy of antileishmaniasis drugs, presenting a critical review and some suggestions for improving drug delivery.

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Current clinical, laboratory, and treatment outcome characteristics of visceral leishmaniasis: results from a seven-year retrospective study in Greece

Abstract: VL is still a common disease in endemic areas, affecting immunocompetent and immunocompromised patients. Its diagnosis is challenging, and molecular techniques are valuable and helpful tools to achieve this. Treatment with L-AMB is safe and very effective.

Cited by 33 publications

References 43 publications

Visceral leishmaniasis in a patient with diabetes mellitus type 2 and discrete bicytopenia

Visceral leishmaniasis in a patient with diabetes mellitus type 2 and discrete bicytopenia

Adverse reactions to meglumine antimoniate in Brazilian inpatients with visceral leishmaniases: A case series

Nanostructured delivery systems with improved leishmanicidal activity: a critical review

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