Epidemiologic, clinical, diagnostic and therapeutic aspects of visceral leishmaniasis in renal transplant recipients: experience from thirty cases

• Published in: BMC infectious diseases Vol. 15; no. 1; p. 96
• Main Authors: de Silva, Avelar Alves, Pacheco e Silva Filho, Álvaro, Sesso, Ricardio de Castro Cinta, Esmeraldo, Ronaldo de Matos, de Oliveira, Cláudia Maria Costa, Fernandes, Paula Frassinetti, de Oliveira, Rodrigo Alves, de Silva, Leila Silveira Veira, de Carvalho, Valencio Pereira, Costa, Carlos Henrique Nery, Andrade, Jesusmar Ximenes, da Silva, Diana Marisa Barros, Chaves, Roosevelt Valente
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 25-02-2015; BioMed Central
• Subjects: Adult; Age Distribution; Amphotericin B - therapeutic use; Animals; Animals, Domestic; Antiprotozoal Agents - therapeutic use; Disease transmission; Epidemiology; Female; Health aspects; Humans; Immunocompromised Host; Immunosuppressive Agents - adverse effects; Kidney Diseases - chemically induced; Kidney Diseases - diagnosis; Kidney Diseases - drug therapy; Kidney Diseases - epidemiology; Kidney Transplantation; Leishmania - isolation & purification; Leishmaniasis, Visceral - chemically induced; Leishmaniasis, Visceral - diagnosis; Leishmaniasis, Visceral - drug therapy; Leishmaniasis, Visceral - epidemiology; Liver; Liver Diseases - diagnosis; Liver Diseases - drug therapy; Liver Diseases - epidemiology; Liver Diseases - etiology; Male; Medical research; Medicine, Experimental; Middle Aged; Physiological aspects; Residence Characteristics; Retrospective Studies; Sex Distribution; Splenic Diseases - chemically induced; Splenic Diseases - diagnosis; Splenic Diseases - drug therapy; Splenic Diseases - epidemiology; Transplant Recipients
• ISSN: 1471-2334; 1471-2334
• DOI: 10.1186/s12879-015-0852-9

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.
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.
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%).
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.