Visceral leishmaniasis in the early post-transplant period after kidney transplantation: clinical features and therapeutic management

Veroux, Massimiliano; Corona, Daniela; Giuffrida, G; Cacopardo, Bruno; Sinagra, N.; Tallarita, Tiziano; Giaquinta, Alessia; Zerbo, D.

doi:10.1111/j.1399-3062.2010.00520.x

Cited by 36 publications

(42 citation statements)

References 13 publications

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“…Overall,~20% of VL cases (n = 6) were diagnosed within the first 3 months after transplantation, and two cases were diagnosed within the first 30 days. A recent report suggested that during early disease onset, transmission is related to the reactivation of a dormant infection, when immunosuppression is at its highest level [18]. Despite this risk, VL screening is not routinely performed because the value of serologic and molecular screening of asymptomatic donors and recipients remains unclear [19,20].…”

Section: Discussionmentioning

confidence: 99%

Risk factors, clinical features and outcomes of visceral leishmaniasis in solid-organ transplant recipients: a retrospective multicenter case–control study

Clemente

Vidal

Girão

et al. 2015

Clinical Microbiology and Infection

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Visceral leishmaniasis (VL) is a rare disease in solid-organ transplant (SOT) recipients. Therefore, little is known about the risk factors and disease behavior in the transplant setting. This multicenter, matched case-control study (1:2 ratio) was designed to determine the risk factors, clinical features and outcomes of VL among this population. Control and case subjects were matched by center, transplant type and timing. Thirty-six VL cases were identified among 25 139 SOT recipients (0.1%). VL occurred 5.7-fold more frequently in Brazil than in Spain, presenting a median time of 11 months after transplantation. High-dose prednisone in the preceding 6 months was associated with VL. Patients were diagnosed over 1 month after symptom onset in 25% of cases. Thirty-one patients (86%) were febrile upon diagnosis, 81% exhibited visceromegaly and 47% showed pancytopenia. Concomitant infection was common. Parasites were identified in 89% of patients; the remaining patients were diagnosed by serology. The majority of the patients received amphotericin B. Relapses occurred in 25.7% of cases, and the crude mortality rate was 2.8%. VL after SOT is related to the VL prevalence in the general population. Delayed diagnosis frequently occurs. Liposomal amphotericin is the most commonly used therapy; mortality is low, although relapses are common. Clinical Microbiology and Infection

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Section: Discussionmentioning

confidence: 99%

Risk factors, clinical features and outcomes of visceral leishmaniasis in solid-organ transplant recipients: a retrospective multicenter case–control study

Clemente

Vidal

Girão

et al. 2015

Clinical Microbiology and Infection

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“…Transplantlı hastalarda viseral leyiş-manyoz primer enfeksiyon şeklinde olabileceği gibi immün süpresif tedaviyle sessiz enfeksiyonun reaktivasyonu sonucunda da gelişebilir 12 . Viseral leyişmanyoz, solid organ transplantasyonlu hastaların %22-37.5'inde tedavinin ilk yılında sıklıkla tekrarlamaktadır 13 . Çalışmamızda böbrek nakli uygulanmış bir olgumuzda dört kez viseral leyişman-yoz reaktivasyonu görülmüş ve olgu son atağında nozokomiyal enfeksiyon nedeniyle kaybedilmiştir.…”

Section: Discussionunclassified

Evaluation of Fourteen Adult Cases with Visceral Leishmaniasis

Kurşun¹,

Turunç²,

Demıroğlu³

et al. 2013

Mikrobiyol Bul

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ÖZETViseral leyişmanyoz ülkemizin de içinde bulunduğu Akdeniz ülkelerinde yaygın olarak görülen, tatarcık sineği (Phlebotomus) tarafından taşınan Leishmania protozoonunun neden olduğu hayatı tehdit eden sistemik bir enfeksiyon hastalığıdır. Bu çalışmada, Ocak 2005-Nisan 2012 tarihleri arasında kliniğimizde izlenen viseral leyişmanyoz olgularının retrospektif olarak irdelenmesi ve literatür ile karşılaştırılması amaç-lanmıştır. Çalışmaya, viseral leyişmanyoz tanısıyla izlenen ve tedavi süreleri tamamlandıktan sonra bir yıl boyunca takip edilen 14 olgu (7 kadın, 7 erkek; yaş aralığı: 19-64 yıl, yaş ortalaması: 41.6 ± 12.9 yıl) alın-mış ve olgulara ait bilgiler hasta dosyalarından elde edilmiştir. Olguların 10'u immünokompetan, dördü immünosüpresif olup, altısı Adana'da sekizi ise güney ve güneydoğu Anadolu bölgesinin farklı illerinde ikamet etmektedir. Olgularda, belirtilerin başlangıcından tanı konuluncaya kadar geçen süre ortalama 75 (aralık: 2-272) gün olup, olguların %79 (11/14)'u daha önce bir sağlık kuruluşuna başvurmuş ve antibiyotik tedavisi almıştır. Olguların en çok ateş yüksekliği (%100), üşüme/titreme (%93), halsizlik (%71) ve kilo kaybı (%57) yakınmaları ile başvurdukları tespit edilmiştir. Fizik muayene bulguları irdelendiğinde; 8 (%57) olguda ateş, 11 (%79) olguda splenomegali ve 7 (%50) olguda hepatosplenomegali saptanmıştır. Olguların laboratuvar verileri değerlendirildiğinde; tümünde (%100) hipoalbünemi ve 10 (%71)'unda pansitopeni tespit edilmiştir. Viseral leyişmanyoz tanısı; 12 (%86) olguda kemik iliği aspirasyonu ve iki olguda doku (karaciğer/dalak) biyopsi örneklerinin yayma preparatında parazitin amastigot formunun gö-rülmesiyle konulmuştur. Tüm hastalardan alınan kemik iliği örneklerinin NNN (Novy-MacNeal-Nicole) be- Geliş Tarihi

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“…The excretion of amphotericin B, pentamidine isethionate and miltefosine in breast milk is [93][94][95][96][97][98]103,[107][108][109][110][111][112][113][114] (Table 3).…”

Section: Resultsmentioning

confidence: 99%

“…An 83-year-old patient with myelodysplastic syndrome was treated successfully with liposomal amphotericin for CL caused by Leishmania major without adverse effects 112 . Renal transplantation patients presenting with VL also had a good response to liposomal amphotericin 110,113 . However, toxicity occurred in patients with LV after heart transplantation, and treatment needed to be interrupted 114 .…”

Section: Human Immunodefi Ciency Virus/acquired Immunodefi Ciencymentioning

confidence: 99%

Treatment of American tegumentary leishmaniasis in special populations: a summary of evidence

Silva

Galvão

Gomes

et al. 2013

Rev. Soc. Bras. Med. Trop.

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Revista da Sociedade Brasileira de Medicina Tropical 46(6):669-677, Nov-Dec, 2013http://dx.doi. org/10.1590/0037-8682-0104-2013 Address to: Dr a Juliana Saboia Fontenele e Silva. Lab. ABSTRACT We aimed to assess and synthesize the information available in the literature regarding the treatment of American tegumentary leishmaniasis in special populations. We searched MEDLINE (via PubMed), EMBASE, LILACS, SciELO, Scopus, Cochrane Library and mRCT databases to identify clinical trials and observational studies that assessed the pharmacological treatment of the following groups of patients: pregnant women, nursing mothers, children, the elderly, individuals with chronic diseases and individuals with suppressed immune systems. The quality of evidence was assessed using the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) approach. The available evidence suggests that the treatments of choice for each population or disease entity are as follows: nursing mothers and children (meglumine antimoniate or pentamidine), patients with renal disease (amphotericin B or miltefosine), patients with heart disease (amphotericin B, miltefosine or pentamidine), immunosuppressed patients (liposomal amphotericin), the elderly (meglumine antimoniate), pregnant women (amphotericin B) and patients with liver disease (no evidence available). The quality of evidence is low or very low for all groups. Accurate controlled studies are required to fi ll in the gaps in evidence for treatment in special populations. Post-marketing surveillance programs could also collect relevant information to guide treatment decision-making.

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Visceral leishmaniasis in the early post-transplant period after kidney transplantation: clinical features and therapeutic management

Cited by 36 publications

References 13 publications

Risk factors, clinical features and outcomes of visceral leishmaniasis in solid-organ transplant recipients: a retrospective multicenter case–control study

Risk factors, clinical features and outcomes of visceral leishmaniasis in solid-organ transplant recipients: a retrospective multicenter case–control study

Evaluation of Fourteen Adult Cases with Visceral Leishmaniasis

Treatment of American tegumentary leishmaniasis in special populations: a summary of evidence

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