Jejunal Function and Pathology in Visceral Leishmaniasis

Muigai, R.; Shaunak, Sunil; Gatei, D.; Wozniak, Arthur; Bryceson, AnthonyD.M.

doi:10.1016/s0140-6736(83)90510-x

Cited by 32 publications

(19 citation statements)

References 3 publications

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“…It results from liver dysfunction, decreased albumin synthesis and reduction in intestinal absorption of proteins due to a protein losing enteropathy 27 . Low serum albumin concentrations decrease the plasma colloidosmotic pressure, and may reduce intravascular negative charges induced to lower Na + attraction into vascular space (Gibbs-Donnan equilibrium), accentuating the hiponatremia 15 .…”

Section: Discussionmentioning

confidence: 99%

Hyponatremia in visceral leishmaniasis

Verde

Veronese

et al. 2010

Rev. Inst. Med. trop. S. Paulo

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SUMMARYThere are few reports linking hyponatremia and visceral leishmaniasis (kala-azar). This is a study of 55 consecutive kala-azar patients and 20 normal individuals as a control group. Hyponatremia and serum hypo-osmolality were detected in 100% of kalaazar patients. High first morning urine osmolality (750.0 ± 52.0 vs. 894.5 ± 30.0mOsm/kg H 2 O, p < 0.05), and high 24-hour urine osmolality (426.0 ± 167.0 vs. 514.6 ± 132.0 mOsm/kg H 2 O, p < 0.05) demonstrated persistent antidiuretic hormone secretion. Urinary sodium was high (82.3 ± 44.2 vs.110.3 ± 34.7 mEq/L, p < 0.05). Low seric uric acid occurred in 61.8% of patients and increased fractional urinary uric acid excretion was detected in 74.5% of them. Increased glomerular filtration rate was present in 25.4% of patients. There was no evidence of extracellular volume depletion. Normal plasma ADH levels were observed in kala-azar patients. No endocrine or renal dysfunction was detected. It is possible that most hyponatremic kala-azar patients present the syndrome of inappropriate antidiuretic hormone secretion.

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Section: Discussionmentioning

confidence: 99%

Hyponatremia in visceral leishmaniasis

Verde

Veronese

et al. 2010

Rev. Inst. Med. trop. S. Paulo

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“…Visceral leishmaniaisis is characterised by the presence of parasitised macrophages in the lamina propria of the small intestine with inflammatory cell infiltration, and can cause chronic diarrhoea with malabsorption of vitamin A and D-xylose. 37 Table 1 shows the treatment of these infections.…”

Section: Protozoal Infectionsmentioning

confidence: 99%

Tropical malabsorption

Ramakrishna

Venkataraman

Mukhopadhya

2006

Postgraduate Medical Journal

125

100

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Malabsorption is an important clinical problem both in visitors to the tropics and in native residents of tropical countries. Infections of the small intestine are the most important cause of tropical malabsorption. Protozoal infections cause malabsorption in immunocompetent hosts, but do so more commonly in the setting of immune deficiency. Helminth infections occasionally cause malabsorption or protein-losing enteropathy. Intestinal tuberculosis, chronic pancreatitis and small-bowel bacterial overgrowth are important causes of tropical malabsorption. In recent years, inflammatory bowel disease and coeliac disease have become major causes of malabsorption in the tropics. Sporadic tropical sprue is still an important cause of malabsorption in adults and in children in South Asia. Investigations to exclude specific infective, immunological or inflammatory causes are important before considering tropical sprue as a diagnosis. This article briefly reviews the management of tropical sprue and presents an algorithm for its investigation and management.

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“…Several experimental animal models of VL have been developed over the years (Abreu-Silva et al 2003;Carrión et al 2006;Garcia-Alonso et al 1996;Keenan et al 1984;Muigai et al 1983;Nieto et al 1996;Prasad and Sen 1996;Ramos et al 1994;Viñuelas et al 2001). Of these, the hamster model most commonly mimics the human disease, given that these animals follow a progressively fatal path following visceral infection (Melby et al 2001a).…”

Section: Introductionmentioning

confidence: 99%

Evaluation of parasitological and immunological parameters of Leishmania chagasi infection in BALB/c mice using different doses and routes of inoculation of parasites

et al. 2011

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Experimental vaccines to protect against visceral leishmaniasis (VL) have been developed by using BALB/c mice infected with a large (10⁷ to 10⁸) inoculum of parasites. Remarkably, prior literature has reported that the poor protection observed is mainly due to the high susceptibility of this strain. To determine factors inherent to mice that might abrogate vaccine-induced efficacy, the present research sought to investigate the impact of the administration of different infective inoculums of Leishmania chagasi (syn. L. infantum) in BALB/c mice, evaluating subcutaneous and intravenous routes of administration as well as parasitological and immunological parameters over different periods of time. This study shows that the injection of a highly infective inoculum in mice, through both subcutaneous and intravenous routes, results in a sustained infection. The mice developed a high parasite load in the liver; however, these values diminished over time. This result did not corroborate with the parasite load in the bone marrow and brain and proved to be expressively different in the spleen and draining lymph nodes, where the values increased over time. Mice infected with a low dose of parasites (10³) showed a certain resistance against infection, based mainly on the IFN-γ and oxide nitric production. Considering all the elements, it could be concluded that the models employing high doses (10⁷) of L. chagasi in BALB/c mice can bring about an imbalance in the animals' immune response, thus allowing for the development of the disease at the expense of efficacy within the vaccine candidates.

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Jejunal Function and Pathology in Visceral Leishmaniasis

Cited by 32 publications

References 3 publications

Hyponatremia in visceral leishmaniasis

Hyponatremia in visceral leishmaniasis

Tropical malabsorption

Evaluation of parasitological and immunological parameters of Leishmania chagasi infection in BALB/c mice using different doses and routes of inoculation of parasites

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