Author:
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-
1.
Herrador Z, Gherasim A, Jimenez BC, Granados M, San Martín JV, Aparicio P, 2015. Epidemiological changes in leishmaniasis in Spain according to hospitalization-based records, 1997–2011: raising awareness towards leishmaniasis in non-HIV patients. PLoS Negl Trop Dis 9: e0003594.
-
2.
Gil-Prieto R, Walter S, Alvar J, de Miguel AG, 2011. Epidemiology of leishmaniasis in Spain based on hospitalization records (1997–2008). Am J Trop Med Hyg 85: 820–825.
-
3.
de Silva AA et al.., 2015. Epidemiologic, clinical, diagnostic and therapeutic aspects of visceral leishmaniasis in renal transplant recipients: experience from thirty cases. BMC Infect Dis 15: 96.
-
4.
Lopez-Velez R, Casado JL, Pintado V, 2001. Decline of a visceral leishmaniasis epidemic in HIV-infected patients after the introduction of highly active antiretroviral therapy (HAART). Clin Microbiol Infect 7: 394–395.
-
5.
Alvar J et al.., 2008. The relationship between leishmaniasis and AIDS: the second 10 years. Clin Microbiol Rev 21: 334–359.
-
6.
Monge-Maillo B, Norman FF, Cruz I, Alvar J, López-Vélez R, 2014. Visceral leishmaniasis and HIV coinfection in the Mediterranean region. PLoS Negl Trop Dis 8: e3021.
-
7.
Boumpas DT, Chrousos GP, Wilder RL, Cupps TR, Balow JE, 1993. Glucocorticoid therapy for immune-mediated diseases. Ann Intern Med 119: 1198–1208.
-
8.
Alves da Silva A et al.., 2013. The risk factors for and effects of visceral leishmaniasis in graft and renal transplant recipients. Transplantation 95: 721–727.
-
9.
Postorino MC et al.., 2011. Visceral leishmaniasis reactivation in transplant patients: a minireview with report of a new case. J Nephrol 24: 530–534.
-
10.
Bassetti M, Pizzorni C, Gradoni L, Del Bono V, Cutolo M, Viscoli C, 2006. Visceral leishmaniasis infection in a rheumatoid arthritis patient treated with adalimumab. Rheumatology (Oxford) 45: 1446–1468.
-
11.
Casabianca A et al.., 2011. Seronegative visceral leishmaniasis with relapsing and fatal course following rituximab treatment. Infection 39: 375–378.
-
12.
De Leonardis F, Govoni M, Lo Monaco A, Trotta F, 2009. Visceral leishmaniasis and anti-TNF-alpha therapy: case report and review of the literature. Clin Exp Rheumatol 27: 503–506.
-
13.
Motta AC, Arruda D, Souza CS, Foss NT, 2003. Disseminated mucocutaneous leishmaniasis resulting from chronic use of corticosteroid. Int J Dermatol 42: 703–706.
-
14.
Fernández-Guerrero ML et al.., 1987. Visceral leishmaniasis in immunocompromised hosts. Am J Med 83: 1098–1102.
-
15.
Fernández-Guerrero ML, Robles P, Rivas P, Mójer F, Muñíz G, de Górgolas M, 2004. Visceral leishmaniasis in immunocompromised patients with and without AIDS: a comparison of clinical features and prognosis. Acta Trop 90: 11–16.
-
16.
Pintado V, Martín-Rabadán P, Rivera ML, Moreno S, Bouza E, 2001. Visceral leishmaniasis in human immunodeficiency virus (HIV)-infected and non-HIV-infected patients. A comparative study. Medicine (Baltimore) 80: 54–73.
-
17.
Daneshbod Y, Dehghani SJ, Nikzad M, Daneshbod K, 2010. Visceral leishmaniasis in a case of acute lymphoblastic leukemia at both remission and relapse, diagnosed by bone marrow aspiration. Acta Cytol 54: 743–746.
-
18.
Mansueto P, Vitale G, Di Lorenzo G, Rini GB, Mansueto S, Cillari E, 2007. Immunopathology of leishmaniasis: an update. Int J Immunopathol Pharmacol 20: 435–445.
-
19.
Guedes-Barbosa LS, Pereira da Costa I, Fernandes V, Henrique da Mota LM, de Menezes I, Aaron Scheinberg M, 2013. Leishmaniasis during anti-tumor necrosis factor therapy: report of 4 cases and review of the literature (additional 28 cases). Semin Arthritis Rheum 43: 152–157.
-
20.
Triadafilopoulos G, 2014. Glucocorticoid therapy for gastrointestinal diseases. Expert Opin Drug Saf 13: 563–572.
-
21.
Stuck AE, Minder CE, Frey FJ, 1989. Risk of infectious complications in patients taking glucocorticosteroids. Rev Infect Dis 11: 954–963.
-
22.
Clemente W et al.., 2015. Risk factors, clinical features and outcomes of visceral leishmaniasis in solid-organ transplant recipients: a retrospective multicenter case-control study. Clin Microbiol Infect 21: 89–95.
-
23.
Bogdan C, 2012. Leishmaniasis in rheumatology, haematology and oncology: epidemiological, immunological and clinical aspects and caveats. Ann Rheum Dis 71 (Suppl 2):i60–i66.
-
24.
Pittalis S, Nicastri E, Spinazzola F, Ghirga P, De Marco M, Paglia MG, Narciso P, 2006. Leishmania infantum leishmaniasis in corticosteroid—treated patients. BMC Infect Dis 6: 177.
-
25.
Karagiannidis GS, Mantzourani M, Meletis J, Anastasopoulou AN, Vaiopoulos GA, 2012. Visceral leishmaniasis in a rheumatoid arthritis patient treated with methotrexate. J Clin Rheumatol 18: 59.
-
26.
Venizelos I, Tatsiou Z, Papathomas TG, Orazi A, 2009. Visceral leishmaniasis in a rheumatoid arthritis patient treated with methotrexate. Int J Infect Dis 13: e169–e172.
-
27.
Maggi P et al.., 2004. Leishmaniasis in patients with chronic renal failure: a diagnostic and therapeutic challenge for the clinician. J Nephrol 17: 296–301.
-
28.
Reus S, Sánchez R, Portilla J, Boix V, Priego M, Merino E, Román F, 1999. Visceral leishmaniasis: a comparative study of patients with and without human immunodeficiency virus infection. Enferm Infecc Microbiol Clin 17: 515–520.
-
29.
Ansari NA, Sharma P, Salotra P, 2007. Circulating nitric oxide and C-reactive protein levels in Indian kala azar patients: correlation with clinical outcome. Clin Immunol 122: 343–348.
-
30.
Schwartz BS, Mawhorter SD, 2013. AST infectious diseases community of practice. Parasitic infections in solid organ transplantation. Am J Transplant 13: 280–303.
-
31.
van Griensven J, Carrillo E, López-Vélez R, Lynen L, Moreno J, 2014. Leishmaniasis in immunosuppresed individuals. Clin Microbiol Infect 20: 286–299.
| Past two years | Past Year | Past 30 Days | |
|---|---|---|---|
| Abstract Views | 39 | 39 | 16 |
| Full Text Views | 534 | 164 | 0 |
| PDF Downloads | 188 | 37 | 0 |
Is Visceral Leishmaniasis Different in Immunocompromised Patients Without Human Immunodeficiency Virus? A Comparative, Multicenter Retrospective Cohort Analysis
José M. Ramos
José M. Ramos
Department of Internal Medicine, Hospital General Universitario de Alicante, Alicante, Spain;
Department of Clinical Medicine, Universidad Miguel Hernández de Elche, Campus of San Juan de Alicante, Alicante, Spain;
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Department of Clinical Medicine, Universidad Miguel Hernández de Elche, Campus of San Juan de Alicante, Alicante, Spain;
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Rafael León
Rafael León
Department of Internal Medicine, Hospital General Universitario de Alicante, Alicante, Spain;
Department of Clinical Medicine, Universidad Miguel Hernández de Elche, Campus of San Juan de Alicante, Alicante, Spain;
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Department of Clinical Medicine, Universidad Miguel Hernández de Elche, Campus of San Juan de Alicante, Alicante, Spain;
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Esperanza Merino
Esperanza Merino
Department of Clinical Medicine, Universidad Miguel Hernández de Elche, Campus of San Juan de Alicante, Alicante, Spain;
Unit of Infectious Diseases, Department of Internal Medicine, Hospital General Universitario de Alicante. Alicante, Spain;
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Unit of Infectious Diseases, Department of Internal Medicine, Hospital General Universitario de Alicante. Alicante, Spain;
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Marta Montero
Marta Montero
Unit of Infectious Diseases and Department of Internal Medicine, Hospital Universitario-Politecnico La Fe, Valencia, Spain
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Asunción Aljibe
Asunción Aljibe
Unit of Infectious Diseases and Department of Internal Medicine, Hospital Universitario-Politecnico La Fe, Valencia, Spain
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Marino Blanes
Marino Blanes
Unit of Infectious Diseases and Department of Internal Medicine, Hospital Universitario-Politecnico La Fe, Valencia, Spain
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Sergio Reus
Sergio Reus
Department of Clinical Medicine, Universidad Miguel Hernández de Elche, Campus of San Juan de Alicante, Alicante, Spain;
Unit of Infectious Diseases, Department of Internal Medicine, Hospital General Universitario de Alicante. Alicante, Spain;
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Unit of Infectious Diseases, Department of Internal Medicine, Hospital General Universitario de Alicante. Alicante, Spain;
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Vicente Boix
Vicente Boix
Department of Clinical Medicine, Universidad Miguel Hernández de Elche, Campus of San Juan de Alicante, Alicante, Spain;
Unit of Infectious Diseases, Department of Internal Medicine, Hospital General Universitario de Alicante. Alicante, Spain;
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Unit of Infectious Diseases, Department of Internal Medicine, Hospital General Universitario de Alicante. Alicante, Spain;
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Miguel Salavert
Miguel Salavert
Department of Clinical Medicine, Universidad Miguel Hernández de Elche, Campus of San Juan de Alicante, Alicante, Spain;
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Joaquín Portilla
Joaquín Portilla
Department of Internal Medicine, Hospital General Universitario de Alicante, Alicante, Spain;
Department of Clinical Medicine, Universidad Miguel Hernández de Elche, Campus of San Juan de Alicante, Alicante, Spain;
Unit of Infectious Diseases, Department of Internal Medicine, Hospital General Universitario de Alicante. Alicante, Spain;
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Department of Clinical Medicine, Universidad Miguel Hernández de Elche, Campus of San Juan de Alicante, Alicante, Spain;
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Although visceral leishmaniasis (VL) can affect immunocompromised patients, data from the human immunodeficiency virus (HIV) infection context are limited, and the characteristics of VL in other immunosuppression scenarios are not well defined. A retrospective review of all cases of VL in immunocompromised patients from January 1997 to December 2014 in two Spanish hospitals on the Mediterranean coast was performed. We included 18 transplant recipients (kidney: 7, liver: 4, lung: 3, heart: 2, and blood marrow: 2), 12 patients with other causes of immunosuppression (myasthenia gravis: 3 and rheumatoid arthritis: 2), and 73 VL HIV-positive patients. Fever was more common in transplant patients (94.4%) and patients with other types of immunosuppression (100%) than in HIV-positive individuals (73.3%). Hepatomegaly was less common in transplant recipients (27.8%) and patients with other types of immunosuppression (41.7%) compared with HIV-positive patients (69.9%) (P = 0.01; P = 0.001, respectively). Patients with other types of immunosuppression had a median leukocyte count of 1.5 × 109/L, significantly lower than HIV-positive patients (2.5 × 109/L) (P = 0.04). Serology was more commonly positive in nontransplant immunosuppressed individuals (75%) and transplant recipients (78.6%) than in HIV-patients (13.8%) (P < 0.001). Antimonial therapy was rarely used in transplant recipients (1.9%) and never in patients with other immunosuppressive conditions, whereas 34.2% of HIV-positive patients received it (P = 0.05 and P = 0.01, respectively). Mortality was 16.7% in both transplant recipients and patients with other immunosuppressive conditions and 15.1% in HIV-positive patients. The features of VL may be different in immunosuppressed patients, with more fever and less hepatomegaly and leukopenia than in HIV-infected patients.
Author Notes
Authors’ addesses: José M. Ramos and Rafael León, Department of Internal Medicine, Hospital General Universitario de Alicante, Alicante, Spain, and Department of Clinical Medicine, Universidad Miguel Hernández de Elche, Campus of San Juan de Alicante, Alicante, Spain, E-mails: jramosrincon@yahoo.es and leonr86@hotmail.com. Esperanza Merino, Sergio Reus, and Vicente Boix, Department of Clinical Medicine, Universidad Miguel Hernández de Elche, Campus of San Juan de Alicante, Alicante, Spain, and Unit of Infectious Diseases, Department of Internal Medicine, Hospital General Universitario de Alicante, Alicante, Spain, E-mails: merinoluc@gmail.com, reus_ser@gva.es, and boix_vic@gva.es. Marta Montero, Asunción Aljibe, and Marino Blanes, Unit of Infectious Diseases and Department of Internal Medicine, Hospital Universitario-Politecnico La Fe, Valencia, Spain, E-mails: martamontero72@gmail.com, asun.aljibe@gmail.com, and blanesmarino@gmail.com. Miguel Salavert, Department of Clinical Medicine, Universidad Miguel Hernández de Elche, Campus of San Juan de Alicante, Alicante, Spain, E-mail: salavert_mig@gva.es. Joaquín Portilla, Department of Internal Medicine, Hospital General Universitario de Alicante, Alicante, Spain, Department of Clinical Medicine, Universidad Miguel Hernández de Elche, Campus of San Juan de Alicante, Alicante, Spain, and Unit of Infectious Diseases, Department of Internal Medicine, Hospital General Universitario de Alicante, Alicante, Spain, E-mail: portilla_joa@gva.es.
ProCite
RefWorks
Reference Manager
BibTeX
Zotero
EndNote
-
1.
Herrador Z, Gherasim A, Jimenez BC, Granados M, San Martín JV, Aparicio P, 2015. Epidemiological changes in leishmaniasis in Spain according to hospitalization-based records, 1997–2011: raising awareness towards leishmaniasis in non-HIV patients. PLoS Negl Trop Dis 9: e0003594.
-
2.
Gil-Prieto R, Walter S, Alvar J, de Miguel AG, 2011. Epidemiology of leishmaniasis in Spain based on hospitalization records (1997–2008). Am J Trop Med Hyg 85: 820–825.
-
3.
de Silva AA et al.., 2015. Epidemiologic, clinical, diagnostic and therapeutic aspects of visceral leishmaniasis in renal transplant recipients: experience from thirty cases. BMC Infect Dis 15: 96.
-
4.
Lopez-Velez R, Casado JL, Pintado V, 2001. Decline of a visceral leishmaniasis epidemic in HIV-infected patients after the introduction of highly active antiretroviral therapy (HAART). Clin Microbiol Infect 7: 394–395.
-
5.
Alvar J et al.., 2008. The relationship between leishmaniasis and AIDS: the second 10 years. Clin Microbiol Rev 21: 334–359.
-
6.
Monge-Maillo B, Norman FF, Cruz I, Alvar J, López-Vélez R, 2014. Visceral leishmaniasis and HIV coinfection in the Mediterranean region. PLoS Negl Trop Dis 8: e3021.
-
7.
Boumpas DT, Chrousos GP, Wilder RL, Cupps TR, Balow JE, 1993. Glucocorticoid therapy for immune-mediated diseases. Ann Intern Med 119: 1198–1208.
-
8.
Alves da Silva A et al.., 2013. The risk factors for and effects of visceral leishmaniasis in graft and renal transplant recipients. Transplantation 95: 721–727.
-
9.
Postorino MC et al.., 2011. Visceral leishmaniasis reactivation in transplant patients: a minireview with report of a new case. J Nephrol 24: 530–534.
-
10.
Bassetti M, Pizzorni C, Gradoni L, Del Bono V, Cutolo M, Viscoli C, 2006. Visceral leishmaniasis infection in a rheumatoid arthritis patient treated with adalimumab. Rheumatology (Oxford) 45: 1446–1468.
-
11.
Casabianca A et al.., 2011. Seronegative visceral leishmaniasis with relapsing and fatal course following rituximab treatment. Infection 39: 375–378.
-
12.
De Leonardis F, Govoni M, Lo Monaco A, Trotta F, 2009. Visceral leishmaniasis and anti-TNF-alpha therapy: case report and review of the literature. Clin Exp Rheumatol 27: 503–506.
-
13.
Motta AC, Arruda D, Souza CS, Foss NT, 2003. Disseminated mucocutaneous leishmaniasis resulting from chronic use of corticosteroid. Int J Dermatol 42: 703–706.
-
14.
Fernández-Guerrero ML et al.., 1987. Visceral leishmaniasis in immunocompromised hosts. Am J Med 83: 1098–1102.
-
15.
Fernández-Guerrero ML, Robles P, Rivas P, Mójer F, Muñíz G, de Górgolas M, 2004. Visceral leishmaniasis in immunocompromised patients with and without AIDS: a comparison of clinical features and prognosis. Acta Trop 90: 11–16.
-
16.
Pintado V, Martín-Rabadán P, Rivera ML, Moreno S, Bouza E, 2001. Visceral leishmaniasis in human immunodeficiency virus (HIV)-infected and non-HIV-infected patients. A comparative study. Medicine (Baltimore) 80: 54–73.
-
17.
Daneshbod Y, Dehghani SJ, Nikzad M, Daneshbod K, 2010. Visceral leishmaniasis in a case of acute lymphoblastic leukemia at both remission and relapse, diagnosed by bone marrow aspiration. Acta Cytol 54: 743–746.
-
18.
Mansueto P, Vitale G, Di Lorenzo G, Rini GB, Mansueto S, Cillari E, 2007. Immunopathology of leishmaniasis: an update. Int J Immunopathol Pharmacol 20: 435–445.
-
19.
Guedes-Barbosa LS, Pereira da Costa I, Fernandes V, Henrique da Mota LM, de Menezes I, Aaron Scheinberg M, 2013. Leishmaniasis during anti-tumor necrosis factor therapy: report of 4 cases and review of the literature (additional 28 cases). Semin Arthritis Rheum 43: 152–157.
-
20.
Triadafilopoulos G, 2014. Glucocorticoid therapy for gastrointestinal diseases. Expert Opin Drug Saf 13: 563–572.
-
21.
Stuck AE, Minder CE, Frey FJ, 1989. Risk of infectious complications in patients taking glucocorticosteroids. Rev Infect Dis 11: 954–963.
-
22.
Clemente W et al.., 2015. Risk factors, clinical features and outcomes of visceral leishmaniasis in solid-organ transplant recipients: a retrospective multicenter case-control study. Clin Microbiol Infect 21: 89–95.
-
23.
Bogdan C, 2012. Leishmaniasis in rheumatology, haematology and oncology: epidemiological, immunological and clinical aspects and caveats. Ann Rheum Dis 71 (Suppl 2):i60–i66.
-
24.
Pittalis S, Nicastri E, Spinazzola F, Ghirga P, De Marco M, Paglia MG, Narciso P, 2006. Leishmania infantum leishmaniasis in corticosteroid—treated patients. BMC Infect Dis 6: 177.
-
25.
Karagiannidis GS, Mantzourani M, Meletis J, Anastasopoulou AN, Vaiopoulos GA, 2012. Visceral leishmaniasis in a rheumatoid arthritis patient treated with methotrexate. J Clin Rheumatol 18: 59.
-
26.
Venizelos I, Tatsiou Z, Papathomas TG, Orazi A, 2009. Visceral leishmaniasis in a rheumatoid arthritis patient treated with methotrexate. Int J Infect Dis 13: e169–e172.
-
27.
Maggi P et al.., 2004. Leishmaniasis in patients with chronic renal failure: a diagnostic and therapeutic challenge for the clinician. J Nephrol 17: 296–301.
-
28.
Reus S, Sánchez R, Portilla J, Boix V, Priego M, Merino E, Román F, 1999. Visceral leishmaniasis: a comparative study of patients with and without human immunodeficiency virus infection. Enferm Infecc Microbiol Clin 17: 515–520.
-
29.
Ansari NA, Sharma P, Salotra P, 2007. Circulating nitric oxide and C-reactive protein levels in Indian kala azar patients: correlation with clinical outcome. Clin Immunol 122: 343–348.
-
30.
Schwartz BS, Mawhorter SD, 2013. AST infectious diseases community of practice. Parasitic infections in solid organ transplantation. Am J Transplant 13: 280–303.
-
31.
van Griensven J, Carrillo E, López-Vélez R, Lynen L, Moreno J, 2014. Leishmaniasis in immunosuppresed individuals. Clin Microbiol Infect 20: 286–299.
| Past two years | Past Year | Past 30 Days | |
|---|---|---|---|
| Abstract Views | 39 | 39 | 16 |
| Full Text Views | 534 | 164 | 0 |
| PDF Downloads | 188 | 37 | 0 |