Visceral Leishmaniasis IN A Patient With Systemic Lupus Erythematosus

Publication date: Available online 30 September 2015 Source:IDCases Author(s): André Filipe dos Santos Silva, João Paulo Branco Calheiros Figueiredo Dias, João Miguel Neves Gonçalves Santos Nuak, Francisca da Rocha Aguiar, José António Araújo Pinto, António Carlos Eugénio Megre Sarmento Visceral leishmaniasis is an infection with an insidious and disabling course caused by parasites of the genus Leishmania. In Europe, it is mostly associated with HIV infection. Systemic lupus erythematosus and its treatment are associated with increased risk of infection, neoplastic and concomitant autoimmune disorders. The association of these diseases may go unnoticed. A 60 year-old Caucasian woman with lupus presented with a one year history of fever, malaise, weakness and weight loss. The highlights on physical examination were pallor, palpable hepatosplenomegaly and low-grade fever. Blood tests showed pancytopenia, hyperproteinemia with hypoalbuminemia and hypergammaglobulinemia; electrophoresis showed a polyclonal gamma curve. Full-body CT scan revealed massive hepatosplenomegaly. Microbiology investigation was negative for the most common pathogens, including tuberculosis. There were no signs of hematologic malignancy in the bone marrow smear. PCR for Leishmania infantum was positive both in blood and bone marrow. The patient was treated with liposomal amphotericin B, and immunosuppression was adjusted. She showed rapid clinical improvement and 6 months later h...
Source: IDCases - Category: Infectious Diseases Source Type: research