FDG-PET/CT findings during immune reconstitution in an HIV-1 patient infected with visceral leishmaniasis

Kyrtatos, Panagiotis G.; Debard, Alexa; Martin‐Blondel, Guillaume; Alvarez, Muriel; Delobel, Pierre; Marchou, B.; Massip, Patrice; Wagner, Thomas

doi:10.1007/s15010-013-0459-2

Cited by 6 publications

(10 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…During the investigation of two cases with the fever of unknown origin, we performed PET-CT. There was an increased F-18 FDG uptake in the spleen (increased diffuse F-18 FDG uptake in the spleen both with and without superimposed hypodense nodules), similar to the patients in the literature (28,29).…”

Section: Conflict Of Interestsupporting

confidence: 82%

Multiple Nodular Lesions in Spleen and Liver in Visceral Leishmaniasis

Kutlu

Herek

et al. 2019

Infect Dis Clin Microbiol

View full text Add to dashboard Cite

Objective:We aimed to describe the clinical, laboratory, and radiological characteristics of visceral leishmaniasis (VL) in our region to find additional clues that can help diagnosis. Materials and Methods:All the patients with VL who admitted to our clinic between January 2010 and January 2018 were reviewed retrospectively. The patients with symptoms and signs suggestive of VL and a positive indirect fluorescent antibody test (IFA) or rapid diagnostic test, and/or direct parasitology consisting of the presence of amastigotes of Leishmania in bone marrow aspirate were included in the study. We collected the demographic and clinical features, laboratory, and radiological information from the hospital database. Results:We present ten (seven males and three females) cases of VL, with the mean age of 53 (range of 31-75). Serological tests such as IFA or rapid diagnostic tests were positive in all patients. Amastigotes of Leishmania were present in only three of eight patients who underwent bone marrow biopsy. Abdominal magnetic resonance imaging or computed tomography revealed that all patients (10/10) had splenomegaly, eight of 10 patients had hepatomegaly, and seven patients had intraabdominal lymphadenopathy. Seven patients had multiple hypodense nodular lesions in the spleen with homogeneous parenchyma. Two patients had nodular lesions in the liver. Two patients died because of multiorgan failure before completing their treatment. The remaining patients completed liposomal amphotericin B treatment and cured.Conclusion: VL should be suspected in the diagnosis of the patients, who had long-term fever, splenomegaly, pancytopenia associated with multiple nodular lesions in the spleen with/without liver involvement.

show abstract

Section: Conflict Of Interestsupporting

confidence: 82%

Multiple Nodular Lesions in Spleen and Liver in Visceral Leishmaniasis

Kutlu

Herek

et al. 2019

Infect Dis Clin Microbiol

View full text Add to dashboard Cite

show abstract

“…Thus, iron overload with hepatosplenomegaly detected in this study may reflect the severe conditions in the Leishmania infection and its associated HLH. Several studies have demonstrated the pattern of Fluorine-18 Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography (F18 FDG-PET/CT) in the visceral leishmaniasis [27][28][29]. Diffuse splenic and bone marrow uptake of FDG is the main feature in the VL patients, and VL associated HLH cases presented more significantly elevated diffuse uptake in the liver, spleen and spinal column.…”

Section: Discussionmentioning

confidence: 99%

Clinical and laboratory characteristics of hemophagocytic lymphohistiocytosis induced by Leishmania infantum infection

Shi

Huang

et al. 2021

PLoS Negl Trop Dis

View full text Add to dashboard Cite

Background Visceral leishmaniasis (VL) could progress to secondary hemophagocytic lymphohistiocytosis (HLH), which is a rare but life-threatening condition with poor prognosis. So far, the clinical and laboratory characteristics of VL associated HLH have not been well elucidated. Method and findings In this study, we retrospectively analyzed the clinical and laboratory profiles between 17 patients with VL associated HLH and 27 patients with VL alone admitted at the Beijing Friendship Hospital, Capital Medical University from May 2016 to March 2021. In addition to the identification of Leishmania infection, hemophagocytosis was identified in bone marrow in the most cases of VL associated HLH (15/17). The patients with VL associated HLH had higher chances of bleeding, hepatomegaly, thrombocytopenia, hypertriglyceridemia, hyperferritinemia, hypofibrinogenemia, elevated secretion of soluble IL-2 receptor or lower NK cell activity compared to patients with VL only. Furthermore, patients with VL associated HLH had higher inflammation status associated with higher levels of Th1 (TNF-α, IFN-γ, IL-1beta, IL-6, IL-8, IL-12p70), Th2 (IL-4) and Th17 cytokines (IL-17, IL-23) in the peripheral blood, and higher parasite load (qPCR and parasite culture). All 27 VL cases were totally recovered after being treated with Sodium Stibogluconate, five of the 17 patients with VL associated HLH died even after timely treatment with anti-parasite and immunosuppressive chemotherapy. Conclusion Without appropriate treatment, visceral leishmaniosis could develop to secondary HLH. The parasite culturing and qPCR detection of bone marrow samples facilitates the diagnosis of VL associated HLH in addition to other findings of HLH. Prompt treatment with anti-Leishmania and immunosuppressive chemotherapy is critical to reduce the mortality of VL associated HLH.

show abstract

“…Though rK39 RDT is highly sensitive and specific, it has limited role in the disease prognosis [14]. Recently, [ 18 F] fluorodeoxyglucose positron emission computed tomography (FDG-PET/CT) imaging has been reported as a useful tool to investigate fevers of unknown origin in HIV-1 patients with VL [15].…”

Section: Introductionmentioning

confidence: 99%