1. Epidemiologic, clinical, diagnostic and therapeutic aspects of visceral leishmaniasis in renal transplant recipients: experience from thirty cases.
- Author
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de Silva AA, Pacheco e Silva Filho Á, Sesso Rde C, Esmeraldo Rde M, de Oliveira CM, Fernandes PF, de Oliveira RA, de Silva LS, de Carvalho VP, Costa CH, Andrade JX, da Silva DM, and Chaves RV
- Subjects
- Adult, Age Distribution, Animals, Animals, Domestic, Female, Humans, Kidney Diseases chemically induced, Kidney Diseases diagnosis, Kidney Diseases drug therapy, Kidney Diseases epidemiology, Leishmania isolation & purification, Leishmaniasis, Visceral chemically induced, Leishmaniasis, Visceral diagnosis, Leishmaniasis, Visceral drug therapy, Liver Diseases diagnosis, Liver Diseases drug therapy, Liver Diseases epidemiology, Liver Diseases etiology, Male, Middle Aged, Residence Characteristics, Retrospective Studies, Sex Distribution, Splenic Diseases chemically induced, Splenic Diseases diagnosis, Splenic Diseases drug therapy, Splenic Diseases epidemiology, Transplant Recipients, Amphotericin B therapeutic use, Antiprotozoal Agents therapeutic use, Immunocompromised Host, Immunosuppressive Agents adverse effects, Kidney Transplantation, Leishmaniasis, Visceral epidemiology
- Abstract
Background: Visceral leishmaniasis is a disease caused by the protozoan Leishmania sp. and is transmitted by Lutzomyia longipalpis (sand fly). In renal transplant recipients, visceral leishmaniasis causes severe damage to the liver, spleen, and hematopoietic system, as well as poor outcomes for patients with transplanted kidneys. This study describes the largest series of cases of visceral leishmaniasis in renal transplant recipients, providing important information about the diagnostic routines and therapeutic strategies in this patient population., Methods: A retrospective, descriptive study was performed to analyze the distribution and evaluate the extent of the epidemiologic, clinical, diagnostic and therapeutic aspects of 30 renal transplant recipients from endemic regions who presented with visceral leishmaniasis in the post-transplantation period., Results: In this study, visceral leishmaniasis was more frequent in men (80%). The mean age of presentation was 40 ± 10.5 years. The majority of patients worked in urban areas (66.7%), cohabitated with domestic animals (90%), and were from low-income households. In 73.3% of cases, diagnosis was made by direct isolation of Leishmania forms. Patients were treated with liposomal amphotericin, resulting in a high degree of disease remission (80%)., Conclusions: This study describes the largest series of visceral leishmaniasis in renal transplant recipients and expands clinical-epidemiological knowledge for transplantation teams to perform adequate disease management for this specific patient population.
- Published
- 2015
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