AA-amyloidosis caused by visceral leishmaniasis in a human immunodeficiency virus-infected patient.
Details
Serval ID
serval:BIB_16F420BDB2DF
Type
Article: article from journal or magazin.
Publication sub-type
Case report (case report): feedback on an observation with a short commentary.
Collection
Publications
Institution
Title
AA-amyloidosis caused by visceral leishmaniasis in a human immunodeficiency virus-infected patient.
Journal
American Journal of Tropical Medicine and Hygiene
ISSN
1476-1645[electronic]
Publication state
Published
Issued date
2009
Volume
81
Number
2
Pages
209-12
Language
english
Notes
Publication types: Case Reports ; Journal Article
Abstract
AA-amyloidosis in the setting of chronic visceral leishmaniasis (VL) has been reported in animal models but documentation in humans is unavailable. Here, we report on a Portuguese man who in 1996 was diagnosed with both human immunodeficiency virus (HIV)-infection and VL. Antiretroviral treatment led to sustained suppression of HIV viremia but CD4+ lymphocytes rose from 8 to only 160 cells/mL. Several courses of antimony treatment did not prevent VL relapses. Renal failure developed in 2006 and renal biopsy revealed AA-amyloidosis. The patient had cryoglobulinemia and serum immune complexes containing antibodies directed against seven leishmanial antigens. Antimony plus amphotericin B, followed by oral miltefosine resulted in a sustained VL treatment response with elimination of circulating Leishmania infantum DNA and CD4+ recovery. The concomitant reduction of serum AA levels and disappearance of circulating leishmanial immune complexes suggests that prolonged VL may lead to AA-amyloidosis in immunocompromised humans.
Keywords
Amphotericin B/therapeutic use, Amyloidosis/complications, Anti-HIV Agents/therapeutic use, Antiprotozoal Agents/therapeutic use, HIV Infections/complications, HIV Infections/drug therapy, Humans, Leishmaniasis, Visceral/complications, Leishmaniasis, Visceral/drug therapy, Male, Meglumine/therapeutic use, Organometallic Compounds/therapeutic use, Young Adult
Pubmed
Web of science
Create date
01/10/2009 9:16
Last modification date
20/08/2019 12:46