Development of Post–Kala-Azar Dermal Leishmaniasis (PKDL) in Miltefosine-Treated Visceral Leishmaniasis

Vidya Nand Rabi Das Division of Clinical Medicine, Division of Pathology, Division of Biochemistry, Division of Immunology, Division of Epidemiology, Division of Microbiology and Molecular Biology, and Division of Biostatistics, Rajendra Memorial Research Institute of Medical Sciences (Indian Council of Medical Research), Agamkuan, Patna, Bihar, India

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Krishna Pandey Division of Clinical Medicine, Division of Pathology, Division of Biochemistry, Division of Immunology, Division of Epidemiology, Division of Microbiology and Molecular Biology, and Division of Biostatistics, Rajendra Memorial Research Institute of Medical Sciences (Indian Council of Medical Research), Agamkuan, Patna, Bihar, India

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Neena Verma Division of Clinical Medicine, Division of Pathology, Division of Biochemistry, Division of Immunology, Division of Epidemiology, Division of Microbiology and Molecular Biology, and Division of Biostatistics, Rajendra Memorial Research Institute of Medical Sciences (Indian Council of Medical Research), Agamkuan, Patna, Bihar, India

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Chandra Shekhar Lal Division of Clinical Medicine, Division of Pathology, Division of Biochemistry, Division of Immunology, Division of Epidemiology, Division of Microbiology and Molecular Biology, and Division of Biostatistics, Rajendra Memorial Research Institute of Medical Sciences (Indian Council of Medical Research), Agamkuan, Patna, Bihar, India

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Sanjeev Bimal Division of Clinical Medicine, Division of Pathology, Division of Biochemistry, Division of Immunology, Division of Epidemiology, Division of Microbiology and Molecular Biology, and Division of Biostatistics, Rajendra Memorial Research Institute of Medical Sciences (Indian Council of Medical Research), Agamkuan, Patna, Bihar, India

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Roshan Kamal Topno Division of Clinical Medicine, Division of Pathology, Division of Biochemistry, Division of Immunology, Division of Epidemiology, Division of Microbiology and Molecular Biology, and Division of Biostatistics, Rajendra Memorial Research Institute of Medical Sciences (Indian Council of Medical Research), Agamkuan, Patna, Bihar, India

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Dharmendra Singh Division of Clinical Medicine, Division of Pathology, Division of Biochemistry, Division of Immunology, Division of Epidemiology, Division of Microbiology and Molecular Biology, and Division of Biostatistics, Rajendra Memorial Research Institute of Medical Sciences (Indian Council of Medical Research), Agamkuan, Patna, Bihar, India

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Niyamat Ali Siddiqui Division of Clinical Medicine, Division of Pathology, Division of Biochemistry, Division of Immunology, Division of Epidemiology, Division of Microbiology and Molecular Biology, and Division of Biostatistics, Rajendra Memorial Research Institute of Medical Sciences (Indian Council of Medical Research), Agamkuan, Patna, Bihar, India

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Rakesh Bihari Verma Division of Clinical Medicine, Division of Pathology, Division of Biochemistry, Division of Immunology, Division of Epidemiology, Division of Microbiology and Molecular Biology, and Division of Biostatistics, Rajendra Memorial Research Institute of Medical Sciences (Indian Council of Medical Research), Agamkuan, Patna, Bihar, India

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Pradeep Das Division of Clinical Medicine, Division of Pathology, Division of Biochemistry, Division of Immunology, Division of Epidemiology, Division of Microbiology and Molecular Biology, and Division of Biostatistics, Rajendra Memorial Research Institute of Medical Sciences (Indian Council of Medical Research), Agamkuan, Patna, Bihar, India

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We report two cases of post–kala-azar dermal leishmaniasis (PKDL), which had subsequently developed after successful treatment of visceral leishmaniasis with miltefosine. Both patients had maculo-nodular lesions all over the body, and they were diagnosed as PKDL by parasitologic examination for Leishmania donovani bodies in a skin snip of lesions. Patients were put on amphotericin B and responded very well for nodular lesions with one course of treatment. However, longer duration of the treatment is needed for total clearance of macular lesions from body surface in PKDL cases. This is the first case report of PKDL in India, which developed after successful treatment of visceral leishmaniasis with miltefosine.

  • 1

    Zijlstra EE, El-Hassan AM, 2001. Leishmaniasis in Sudan: post-kala-azar dermal leishmaniasis. Tran R Soc Trop Med Hyg 95 (Suppl 1):S59–S76.

    • Search Google Scholar
    • Export Citation
  • 2

    Dutta M, Ghosh TK, 1983. Review of current status of leishmaniasis epidemiology, Proceedings of the Indo-UK Workshop on Leishmaniasis, New Delhi: Indian Council of Medical Research: 97–102.

  • 3

    World Health Organization, 1978. A Decade of Health Development in South-east Asia. South-east Asia Regional Publication Series No. 7. New Delhi: World Health Organization.

  • 4

    Ranjan A, Sur D, Singh VP, Siddique NA, Manna B, Lal CS, Sinha PK, Kishore K, Bhattacharya SK, 2005. Risk factors for Indian kala-azar. Am J Trop Med Hyg 73 :74–78.

    • Search Google Scholar
    • Export Citation
  • 5

    Bhattacharya SK, Sinha PK, Sunder S, Thakur CP, Jha TK, Pandey K, Das VNR, Kumar N, Lal CS, Verma N, Singh VP, Ranjan A, Verma RK, Anders G, Sindermann H, Ganguly NK, 2007. Phase 4 trial of miltefosine for the treatment of Indian visceral leishmaniasis. J Infect Dis 196 :591–598.

    • Search Google Scholar
    • Export Citation
  • 6

    Sharma MC, Gupta AK, Verma N, Das VN, Saran R, Kar SK, 2000. Demonstration of Leishmania parasites in skin lesions of Indian post kala-azar dermal leishmaniasis (PKDL) cases. J Commun Dis 32 :67–68.

    • Search Google Scholar
    • Export Citation
  • 7

    Salotra P, Singh R, 2006. Challenges in the diagnosis of post kala-azar dermal leishmaniasis. Indian J Med Res 123 :295–310.

  • 8

    Das VNR, Ranjan A, Bimal S, Siddique NA, Pandey K, Kumar N, Verma N, Singh VP, Sinha PK, Bhattacharya SK, 2005. Magnitude of unresponsiveness to sodium stibogluconate in the treatment of visceral leishmaniasis in Bihar. Natl Med J India 18 :131–133.

    • Search Google Scholar
    • Export Citation
  • 9

    Thakur CP, Narain S, Kumar N, Hasaan SM, Jha DK, Kumar A, 1997. Amphotericin B is superior to sodium antimony glucon-ate in the treatment of Indian post kala-azar dermal leishmaniasis. Ann Trop Med Parasitol 91 :611–616.

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