Visceral leishmaniasis complicating systemic lupus erythematosus

Wallis, P. J. W.; Clark, Cari J.

doi:10.1136/ard.42.2.201

Cited by 22 publications

(9 citation statements)

References 2 publications

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“…These patients experienced relapses of VL despite therapy with amphotericin. VL was diagnosed in a woman with lupus on steroids who developed VL five years after living in Hong Kong and was suspected of having activation of latent disease in the setting of immunosupression [Wallis and Clark, 1983]. …”

Section: Visceral Leishmaniasis During Usage Of Immunomodulatory Agenmentioning

confidence: 99%

New challenges in the epidemiology and treatment of visceral leishmaniasis in periurban areas

Dupnik

Nascimento

Rodrigues-Neto

et al. 2011

Drug Development Research

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Visceral leishmaniasis [VL] represents a major public health problem in many areas of the world. This review focuses on the impact of periurbanization on the epidemiology and treatment of VL, using Brazil as an example. VL continues to be mostly a disease of poverty with impact on families. However, the disease has expanded in Latin America, with foci reported as far south as Argentina. There is an increasing overlap of Leishmania infantum chagasi and HIV infections and other immunosuppressive conditions, resulting in VL emerging as an opportunistic infection. This new setting poses new challenges for VL disease control and patient management.

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Section: Visceral Leishmaniasis During Usage Of Immunomodulatory Agenmentioning

confidence: 99%

New challenges in the epidemiology and treatment of visceral leishmaniasis in periurban areas

Dupnik

Nascimento

Rodrigues-Neto

et al. 2011

Drug Development Research

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“…Recent reports have indicated that spontaneously controlled (subclinical) infections caused by the intracellular protozoan, Leishmania donovani, may reactivate in immunocompromised patients (1)(2)(3)(4)(5)(6)(7). In addition, primary treatment Receivedfor publication 27 May 1988 and in revisedform 18 November 1988. failures using ordinarily effective pentavalent antimony (e.g., sodium stibogluconate, or Pentostam [proprietary name of Burroughs Wellcome]) as well as prompt relapses have also been described in Leishmania donovani-infected patients who have AIDS or are receiving immunosuppressive agents (5)(6)(7).…”

Section: Introductionmentioning

confidence: 99%

Requirement for T cells and effect of lymphokines in successful chemotherapy for an intracellular infection. Experimental visceral leishmaniasis.

Murray

J²,

Granger³

et al. 1989

J. Clin. Invest.

117

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Although directly microbicidal, pentavalent antimony has failed as treatment for visceral leishmaniasis in patients who also have AIDS or are receiving immunosuppressive therapy. To define the role of T cells in the successful host response to chemotherapy, we examined the efficacy of pentavalent antimony (sodium stibogluconate, Pentostam) in normal and T cell-deficient BALB/c mice infected with Leishmania donovani. In euthymic (nu/+) mice, single injections of 250 and 500 mg/kg of Pentostam induced the killing of 67% and 89% of intracellular liver amastigotes, respectively. In contrast, in athymic nude (nu/nu) mice, up to three injections of 500 mg/kg achieved no L. donovani killing and did not retard visceral parasite replication. Once nude mice were reconstituted with nu/+ spleen cells, however, Pentostam exerted strong leishmanicidal activity, an effect that appeared to be transferred by either L3T4+ or Lyt-2+ cells. Responsiveness to chemotherapy could also be induced by providing nude mice with either interferon-'y or interleukin 2 alone. The absence of this T cell-and probably lymphokine-dependent mechanism is a likely explanation for treatment failures in immunocompromised patients infected with L. donovani and perhaps other systemic intracellular pathogens as well.

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“…Early recognition of Leishmania infection in patients with SLE is essential because intense immunosuppression may transform visceral leishmaniasis into a rapidly progressive disease. This is very dif cult to treat with the current antiparasitic therapy and eventually leads to a fatal outcome, as occurred in two of the ve patients reported in the English language literature (3)(4)(5)(6). A high index of suspicion is necessary for an early diagnosis because fever and pancytopenia are also common in active SLE and, as in our observation, the two other typical features of leishmaniasis, hepatosplenomegaly and hypergammaglobulinaemia, may be absent.…”

mentioning

confidence: 49%

Visceral leishmaniasis as a cause of unexplained fever and cytopenia in systemic lupus erythematosus

et al. 2002

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Visceral leishmaniasis complicating systemic lupus erythematosus

Abstract: Active systemic lupus erythematosus in a 32-year-old Chinese woman was successfully controlled by plasmapheresis and steroids. However, occult visceral leishmaniasis was uncovered during therapy and responded to appropriate treatment.

Cited by 22 publications

References 2 publications

New challenges in the epidemiology and treatment of visceral leishmaniasis in periurban areas

New challenges in the epidemiology and treatment of visceral leishmaniasis in periurban areas

Requirement for T cells and effect of lymphokines in successful chemotherapy for an intracellular infection. Experimental visceral leishmaniasis.

Visceral leishmaniasis as a cause of unexplained fever and cytopenia in systemic lupus erythematosus

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