AA-amyloidosis caused by visceral leishmaniasis in a human immunodeficiency virus-infected patient.
Détails
ID Serval
serval:BIB_16F420BDB2DF
Type
Article: article d'un périodique ou d'un magazine.
Sous-type
Etude de cas (case report): rapporte une observation et la commente brièvement.
Collection
Publications
Institution
Titre
AA-amyloidosis caused by visceral leishmaniasis in a human immunodeficiency virus-infected patient.
Périodique
American Journal of Tropical Medicine and Hygiene
ISSN
1476-1645[electronic]
Statut éditorial
Publié
Date de publication
2009
Volume
81
Numéro
2
Pages
209-12
Langue
anglais
Notes
Publication types: Case Reports ; Journal Article
Résumé
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.
Mots-clé
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
Création de la notice
01/10/2009 10:16
Dernière modification de la notice
20/08/2019 13:46