OBJECTIVE: To compare the clinical and laboratorial data before and after the treatment of patients with visceral leishmaniasis admitted to a pediatric hospital in a nonendemic area, highlighting the importance of recognizing visceral leishmaniasis in pediatric patients. METHODS: Clinical, laboratorial and treatment data of 78 patients with visceral leishmaniasis were evaluated from 1981 to 1992. We analyzed the average level of hemoglobin, leukocyte, neutrophil, platelet, albumin, gammaglobulin, class and subclass of immunoglobulin, size of the liver and spleen during the pre- and post-treatment using the paired t test. RESULTS: We included 78 patients with visceral leishmaniasis, 44 males, with age ranging from 8 months to 13.5 years. Sixty-one patients were from Bahia. Fever and splenomegaly were present in 96.1% and 100% of the cases, respectively. The parasitological diagnosis was obtained in 74/78 patients: 67 patients through smear and/or culture of bone marrow (85.7%), five through liver biopsy and two through spleen puncture. The hematological findings and serum albumin presented significant improvement at the end of treatment (P<0.001), differently from serum gammaglobulin levels (P=0.087). There was predominance of IgG1 subclass, with two patients presenting low levels of IgG2. Initial treatment used antimoniate in 67 cases and amphotericin B in five. Eleven patients (15.7%) needed a second treatment, and were considered cured after it. There was significant improvement in the liver and spleen size at the end of the treatment (P<0.001). One patient presented spontaneous remission and five died due to bleeding. CONCLUSIONS: In order to obtain accurate diagnosis and treatment, especially regarding health services of areas with low-incidence of visceral leishmaniasis, the diagnosis of patients with fever and visceromegaly, who come from endemic areas, should include visceral leishmaniasis.
OBJECTIVE: To compare the clinical and laboratorial data before and after the treatment of patients with visceral leishmaniasis admitted to a pediatric hospital in a nonendemic area, highlighting the importance of recognizing visceral leishmaniasis in pediatric patients. METHODS: Clinical, laboratorial and treatment data of 78 patients with visceral leishmaniasis were evaluated from 1981 to 1992. We analyzed the average level of hemoglobin, leukocyte, neutrophil, platelet, albumin, gammaglobulin, class and subclass of immunoglobulin, size of the liver and spleen during the pre- and post-treatment using the paired t test. RESULTS: We included 78 patients with visceral leishmaniasis, 44 males, with age ranging from 8 months to 13.5 years. Sixty-one patients were from Bahia. Fever and splenomegaly were present in 96.1% and 100% of the cases, respectively. The parasitological diagnosis was obtained in 74/78 patients: 67 patients through smear and/or culture of bone marrow (85.7%), five through liver biopsy and two through spleen puncture. The hematological findings and serum albumin presented significant improvement at the end of treatment (P<0.001), differently from serum gammaglobulin levels (P=0.087). There was predominance of IgG1 subclass, with two patients presenting low levels of IgG2. Initial treatment used antimoniate in 67 cases and amphotericin B in five. Eleven patients (15.7%) needed a second treatment, and were considered cured after it. There was significant improvement in the liver and spleen size at the end of the treatment (P<0.001). One patient presented spontaneous remission and five died due to bleeding. CONCLUSIONS: In order to obtain accurate diagnosis and treatment, especially regarding health services of areas with low-incidence of visceral leishmaniasis, the diagnosis of patients with fever and visceromegaly, who come from endemic areas, should include visceral leishmaniasis.
Authors: Robson A A da Silva; Natália M Tavares; Dirceu Costa; Maiana Pitombo; Larissa Barbosa; Kyioshi Fukutani; Jose C Miranda; Camila I de Oliveira; Jesus G Valenzuela; Aldina Barral; Manuel Soto; Manoel Barral-Netto; Cláudia Brodskyn Journal: Acta Trop Date: 2011-08-22 Impact factor: 3.112
Authors: Aírton M C Júnior; Fernando A de Amorim Carvalho; Weslany de Oliveira Dantas; Luana C L Gomes; Andrezza B S da Silva; Maria M A de Sousa Cavalcante; Ingrid M de Oliveira; Marina de Deus Moura de Lima; Márcia Dos Santos Rizzo; Carla Maria de Carvalho Leite; Selma Maria Dos Santos Moura; Lúcia de Fátima Almeida de Deus Moura; Benedito B da Silva Journal: Exp Biol Med (Maywood) Date: 2015-11-13
Authors: Anna Raquel Ribeiro Dos Santos; Ângela Vieira Serufo; Maria Marta Figueiredo; Lara Carvalho Godoi; Jéssica Gardone Vitório; Andreza Pain Marcelino; Daniel Moreira de Avelar; Fernandes Tenório Gomes Rodrigues; George Luiz Lins Machado-Coelho; Fernanda Alvarenga Cardoso Medeiros; Selma Maria Bezerra Jerônimo; Edward José de Oliveira; Frederico Crepaldi Nascimento; Santuza Maria Ribeiro Teixeira; Ricardo Tostes Gazzinelli; Ronaldo Alves Pinto Nagem; Ana Paula Fernandes Journal: Mem Inst Oswaldo Cruz Date: 2019-02-04 Impact factor: 2.743
Authors: Ana Nilce S Maia-Elkhoury; Gustavo Adolfo Sierra Romero; Samantha Y O B Valadas; Marcia L Sousa-Gomes; José Angelo Lauletta Lindoso; Elisa Cupolillo; Jose Antonio Ruiz-Postigo; Daniel Argaw; Manuel J Sanchez-Vazquez Journal: PLoS Negl Trop Dis Date: 2019-12-19