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Shamsian SA, Fata A, Alinezhad R, Mohebali M, Sadabadi F, Moghaddas E, Fakhar M. Clinical and Laboratory Findings of Visceral Leishmaniasis in Children Hospitalized in Mashhad, Northeastern Iran: A Twenty-Year Retrospective Study. IRANIAN JOURNAL OF PARASITOLOGY 2020; 15:495-499. [PMID: 33884006 PMCID: PMC8039489 DOI: 10.18502/ijpa.v15i4.4854] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Background: Over the last decade, a few cases of visceral leishmaniasis (VL) have been reported in some provinces of northeastern Iran. We aimed to investigate clinical and laboratory findings of VL among children who admitted to the pediatric ward in a referral hospital in Mashhad, northeastern Iran. Methods: A retrospective study, between 1997 and 2017, was performed on the data sheet registered for children with confirmed VL at the referral Emam Reza Hospital in Mashhad. Hematological and biochemical profiles of the patients were analyzed. Results: A total of 35 children with VL, confirmed by the presence of amastigotes of Leishmania in Giemsa stained smears of the bone marrow, had been recorded through 20 yr. The mean age of patients was 3.7±4 yr. The majority of the patients suffered from hepatosplenomegaly (100%, n=35/35), followed by prolonged fever and pallor (91%, n=32/35), weight loss (85%, n=30/35). The main laboratory findings were anemia (94.1%), leukopenia (52.9%) and thrombocytopenia (70.5%). Almost one-third (37.1%; 13/35) of VL patients inhabited in rural areas of the Bojnoord district as a known VL endemic focus in northeastern Iran. Conclusion: Our preliminary data showed that the origin of VL is still in some districts other than Mashhad, where VL just will be diagnosed.
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Affiliation(s)
- Seyed Aliakbar Shamsian
- Department of Parasitology and Mycology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.,Iranian Academic Center for Education, Culture, and Research (ACECR), Mashhad, Iran
| | - Abdolmajid Fata
- Department of Parasitology and Mycology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.,Cutaneous Leishmaniasis Research Center, Mashhad University of Medical Science, Mashhad, Iran
| | - Reza Alinezhad
- Department of Parasitology and Mycology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mehdi Mohebali
- Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Sadabadi
- Department of Parasitology and Mycology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Elham Moghaddas
- Department of Parasitology and Mycology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mahdi Fakhar
- Toxoplasmosis Research Center, Department of Parasitology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
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Schwing A, Pomares C, Majoor A, Boyer L, Marty P, Michel G. Leishmania infection: Misdiagnosis as cancer and tumor-promoting potential. Acta Trop 2019; 197:104855. [PMID: 30529443 DOI: 10.1016/j.actatropica.2018.12.010] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2018] [Revised: 12/03/2018] [Accepted: 12/06/2018] [Indexed: 12/17/2022]
Abstract
Given the prevalence of cancer and leishmaniasis worldwide, the presence of these two pathologies in the same tissue sample may be merely fortuitous. The clinical outcome of both diseases is under the control of innate and adaptive immunity, and in both cases these progressive diseases are characterized by an impaired host Th1 response. As a consequence, the Th2 cytokine microenvironment occurring in progressive leishmaniasis may potentially promote tumor cell proliferation and vice versa. On the other hand, clinical aspects of subclinical cutaneous or visceral leishmaniasis sometimes closely resemble those observed in various neoplasms thus leading to misdiagnosis. In this review, we present recent findings on the association between leishmaniasis and malignant disorders. Our review includes HIV positive, HIV negative subjects and patients whose HIV status has not been established. Leishmaniasis mimicking a malignant disorder was confirmed and extended to unreported neoplastic disorders including squamous cell carcinoma, T-cell and B-cell lymphoma, oral and intranasal tumors and granulomas. Thus, leishmaniasis should be considered in the differential diagnosis and course of various cancers in Leishmania endemic areas or in patients with travel history to these areas. We also listed recent reports showing that Leishmania can promote cancer development in immunocompromised as well as in immunocompetent patients. The potential mechanisms supporting this promoting effect are discussed.
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Asfaram S, Fakhar M, Mohebali M, Mardani A, Banimostafavi ES, Ziaei Hezarjaribi H, Soosaraei M. Asymptomatic human blood donors carriers of Leishmania infantum: Potential reservoirs for visceral leishmaniasis in northwestern Iran. Transfus Apher Sci 2017. [PMID: 28648574 DOI: 10.1016/j.transci.2017.06.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
BACKGROUND Little is known regarding transfusion-transmitted leishmaniasis (TTL) and the real global incidence of visceral leishmaniasis (VL) among blood donors as carriers of Leishmania spp. in endemic VL foci including Iran. Recent epidemiological evidences indicate that blood donor may be harbor of Leishmania infantum (L. infantum) infection in Iran. METHODS The aim of the present study was to determine the prevalence of Leishmania infection among blood donors in a main endemic focus of VL in Iran using DAT and polymerase chain reaction (PCR) based methods Between July-September 2016, blood samples were collected from 600 apparently healthy blood donors from six blood donation centers and blood donation mobile unit in Ardabil Province, where VL cases had been recorded. Each of these samples was tested for anti-Leishmania antibodies, in direct agglutination test (DAT), and for L. infantum kDNA, the PCR-based assay. RESULTS Of 600 blood donors, which were examined, 23 (3.8%) blood donors were seropositive by DAT and of 23 seropositive subjects, 82.6% (19/23) were positive by PCR. All the seropositive cases were males except one of them was female. CONCLUSIONS Our findings showed that many asymptomatic human carriers of L. infantum live in the endemic regions of northwestern Iran and potentially act as reservoirs of infection; those must be considered carefully by arrangement VL control strategies in the country.
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Affiliation(s)
- Shabnam Asfaram
- Student Research Committee, Department of Parasitology and Mycology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mahdi Fakhar
- Molecular and Cell Biology Research Center, Department of Parasitology and Mycology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran.
| | - Mehdi Mohebali
- Department of Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Ahmad Mardani
- Department of Microbiology, Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine, Tehran, Iran
| | | | - Hajar Ziaei Hezarjaribi
- Molecular and Cell Biology Research Center, Department of Parasitology and Mycology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Masoud Soosaraei
- Student Research Committee, Department of Parasitology and Mycology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
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Sánchez-Montalvá A, Salvador F, Ruiz-Camps I, Barba P, Valcárcel D, Sulleiro E, Sanz-García E, Molina I. Imported Disease Screening Prior to Chemotherapy and Bone Marrow Transplantation for Oncohematological Malignancies. Am J Trop Med Hyg 2016; 95:1463-1468. [PMID: 27928093 DOI: 10.4269/ajtmh.16-0458] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2016] [Accepted: 09/06/2016] [Indexed: 01/03/2023] Open
Abstract
Reactivation of latent imported infections has been periodically reported in migrant patients undergoing immunosuppression. We performed a prospective study at Vall d'Hebron University Hospital (Barcelona, Spain). Migrant patients over 16 years with the diagnosis of any oncohematologic disease were included. Patients were tested for soil-transmitted helminths, hepatitis virus, and human immunodeficiency virus, Treponema pallidum, human T-cell lymphotropic virus, latent tuberculosis infection, Toxoplasma spp., Plasmodium infection, Schistosoma spp., Trypanosoma cruzi infection, Leishmania spp., and dimorphic fungi. Patients were treated and followed for 1 year to assess reactivation. A total of 42 patients were included in this study. Median age was 39 (31-51) years. Twenty-five (59.5%) patients were women. More than half of the patients were of Latin American origin. Sixteen patients (38.1%) underwent hematopoietic stem cell transplantation. Of the patients, 71.4% had at least one imported infection. Patients with at least one positive result in the screening did not show any statistically significant association with the studied variables. We did not find any reactivation of the treated latent infections. After specific treatment we did not observe any reactivation. Screening of latent imported infections previous to an immunosuppressive treatment is easy to perform and it may be lifesaving.
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Affiliation(s)
- Adrián Sánchez-Montalvá
- Infectious Disease Department, Vall d'Hebron University Hospital, PROSICS Barcelona, Universitat Autònoma de Barcelona, Barcelona, Spain.
| | - Fernando Salvador
- Infectious Disease Department, Vall d'Hebron University Hospital, PROSICS Barcelona, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Isabel Ruiz-Camps
- Infectious Disease Department, Vall d'Hebron University Hospital, PROSICS Barcelona, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Pere Barba
- Hematological Department, Vall d'Hebron University Hospital, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - David Valcárcel
- Hematological Department, Vall d'Hebron University Hospital, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Elena Sulleiro
- Microbiology Department, Vall d'Hebron University Hospital, PROSICS Barcelona, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Enrique Sanz-García
- Medical Oncology Department, Vall d'Hebron University Hospital, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Israel Molina
- Infectious Disease Department, Vall d'Hebron University Hospital, PROSICS Barcelona, Universitat Autònoma de Barcelona, Barcelona, Spain
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Julhakyan UL, Magomedova AU, Dvirnyk VN, Kravchenko SK. [Visceral leishmaniasis concurrent with splenic marginal zone B-cell lymphoma]. TERAPEVT ARKH 2016; 88:78-80. [PMID: 27030189 DOI: 10.17116/terarkh201688278-80] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Splenic marginal zone B-cell lymphoma (SMZBCL) is a rare non-Hodgkin B-cell lymphoma that presents with morphologically mature lymphoid cells corresponding in their immunological characteristics to secondary follicular marginal zone lymphocytes. It is clinically characterized by splenomegaly, moderate lymphocytosis, usually focal bone marrow lesion, sometimes moderate of monoclonal immunoglobulin in the serum (generally IgM or IgG) and/or urea, and a relatively benign course. Leishmaniasis is a transmissible natural focal infectious endemic disease that has a great diversity of clinical manifestations. The authors describe Russia's first case of SMZBCL concurrent with visceral leishmaniasis in a 52-year-old female patient admitted to a hematology hospital with weakness, splenomegaly, and lymphadenopathy. The simultaneous detection of lymphoma and leishmaniasis in the same biopsy specimen is extremely rare. Visceral leishmaniasis should be borne in mind as an opportunistic infection in patients with malignancies, particularly in immunocompromised persons who live or have stayed in the endemic areas.
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Affiliation(s)
- U L Julhakyan
- National Research Center for Hematology, Ministry of Health of the Russian Federation, Moscow, Russia
| | - A U Magomedova
- National Research Center for Hematology, Ministry of Health of the Russian Federation, Moscow, Russia
| | - V N Dvirnyk
- National Research Center for Hematology, Ministry of Health of the Russian Federation, Moscow, Russia
| | - S K Kravchenko
- National Research Center for Hematology, Ministry of Health of the Russian Federation, Moscow, Russia
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Caniza MA, Odio C, Mukkada S, Gonzalez M, Ceppi F, Chaisavaneeyakorn S, Apiwattanakul N, Howard SC, Conter V, Bonilla M. Infectious complications in children with acute lymphoblastic leukemia treated in low-middle-income countries. Expert Rev Hematol 2015. [PMID: 26211675 DOI: 10.1586/17474086.2015.1071186] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Infections are the most important cause of morbidity and mortality in children treated for acute lymphoblastic leukemia (ALL). The rates of infection-associated mortality are up to 10-times higher in low- and middle-income countries (LMIC) than in high-income countries. The prevention, early recognition and management of infectious complications is especially challenging in LMIC because of disease and poverty-related factors, as well as the shortage of trained personnel, supplies, diagnostic tools and adequate organizational infrastructure. Children in LMIC with ALL, who are frequently underweight, are at increased risk of community-acquired pathogens, nosocomial multidrug-resistant pathogens and opportunistic microorganisms. This review summarizes the challenges of managing the major categories of infections in children receiving treatment for ALL and provides updated practical recommendations for preventing and managing these infections in LMIC.
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Affiliation(s)
- Miguela A Caniza
- a 1 Department of Infectious Diseases, St. Jude Children's Research Hospital, Memphis, TN, USA
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El Youssi H, Touaoussa A, Bergui I, Bougrine N, Moncef, Amrani H. [Visceral leishmaniasis and acute lymphoblastic leukemia B: what is the relationship?]. Pan Afr Med J 2015; 20:53. [PMID: 26090011 PMCID: PMC4449989 DOI: 10.11604/pamj.2015.20.53.6013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2014] [Accepted: 01/13/2015] [Indexed: 11/11/2022] Open
Affiliation(s)
| | | | - Imane Bergui
- Laboratoire d'Hématologie CHU Hassan II, Fès, Maroc
| | | | - Moncef
- Laboratoire d'Hématologie CHU Hassan II, Fès, Maroc
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The concurrent occurrence of Leishmania chagasi infection and childhood acute leukemia in Brazil. Rev Bras Hematol Hemoter 2014; 36:356-62. [PMID: 25305169 PMCID: PMC4318380 DOI: 10.1016/j.bjhh.2014.07.013] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2013] [Accepted: 06/04/2014] [Indexed: 11/22/2022] Open
Abstract
Objective This study investigated the co-existence of Leishmania chagasi infection and childhood leukemia in patients naïve to treatment; this has serious clinical and epidemiological implications. Methods The seroprevalence of L. chagasi antibodies prior to any treatment was investigated in children with clinical features of acute leukemia. Serological tests were performed in 470 samples drawn from under 14-year-old children from different regions of Brazil with clinical suspicion of acute leukemia. Acute leukemia subtypes were characterized by immunophenotyping using flow cytometry. Morphological analyses of bone marrow aspirates were systematically performed to visualize blast cells and/or the formation of L. chagasi amastigotes. Data analysis used a standard univariate procedure and the Pearson's chi-square test. Results The plasma of 437 children (93%) displayed antibodies against L. chagasi by indirect immunofluorescence assay and enzyme-linked immunosorbent assay tests. Of the 437 patients diagnosed from 2002 to 2006, 254 had acute lymphoblastic leukemia, 92 had acute myeloid leukemia, and 91 did not have acute leukemia. The seroprevalence of L. chagasi antibodies according to the indirect immunofluorescence assay test (22.5%) was similar in children with or without acute leukemia (p-value = 0.76). The co-existence of visceral leishmanasis and acute leukemia was confirmed in 24 children. The overall survival of these children was poor with a high death rate during the first year of leukemia treatment. Conclusion In the differential diagnosis of childhood leukemia, visceral leishmanasis should be considered as a potential concurrent disease in regions where L. chagasi is endemic.
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Yadav YK, Sipayya V, Khanna G, Gupta O. Filariasis in an infant with B-cell acute lymphoblastic leukemia: a rare enigma. J Parasit Dis 2013; 36:122-4. [PMID: 23543795 DOI: 10.1007/s12639-011-0071-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2011] [Accepted: 08/17/2011] [Indexed: 11/27/2022] Open
Abstract
Filariasis, a tropical parasitic infection, is a common public health problem in the Indian sub-continent. Occurrence of filariasis with acute lymphoblastic leukemia (ALL) is unusual, particularly in infants, since filariasis has a long incubation period of about 1 year. Though, there are case reports of leishmaniasis, malaria and other vector borne diseases seen in association with leukemias, filariasis co-existing with ALL has not been documented to the best of our knowledge. We report an incidental finding of Bancroftian filariasis in an 11 month old female already diagnosed as B-cell ALL.
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Affiliation(s)
- Yogesh Kumar Yadav
- Department of Pathology, Safdarjung Hospital and V. M. M. College, New Delhi, India
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Dupnik KM, Nascimento EL, Rodrigues-Neto JF, Keesen T, Fernandes MZ, Duarte I, Jeronimo SMB. New challenges in the epidemiology and treatment of visceral leishmaniasis in periurban areas. Drug Dev Res 2011; 72:451-462. [PMID: 25821334 DOI: 10.1002/ddr.20452] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Visceral leishmaniasis [VL] represents a major public health problem in many areas of the world. This review focuses on the impact of periurbanization on the epidemiology and treatment of VL, using Brazil as an example. VL continues to be mostly a disease of poverty with impact on families. However, the disease has expanded in Latin America, with foci reported as far south as Argentina. There is an increasing overlap of Leishmania infantum chagasi and HIV infections and other immunosuppressive conditions, resulting in VL emerging as an opportunistic infection. This new setting poses new challenges for VL disease control and patient management.
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Affiliation(s)
- Kathryn M Dupnik
- Division of Infectious Diseases, Weill Cornell Medical College, New York, NY, USA ; Instituto Nacional de Ciência e Tecnologia de Doenças Tropicais, INCT-DT, Brazil
| | - Eliana L Nascimento
- Instituto Nacional de Ciência e Tecnologia de Doenças Tropicais, INCT-DT, Brazil ; Department of Infectious Diseases, Universidade Federal do Rio Grande do Norte, Natal, RN, Brazil
| | - Joao F Rodrigues-Neto
- Department of Biochemistry, Universidade Federal do Rio Grande do Norte, Natal, RN, Brazil
| | - Tatjana Keesen
- Department of Biochemistry, Universidade Federal do Rio Grande do Norte, Natal, RN, Brazil
| | - Maria Zélia Fernandes
- Health Post-Graduate Program, Universidade Federal do Rio Grande do Norte, Natal, RN, Brazil ; Department of Internal Medicine, Universidade Federal do Rio Grande do Norte, Natal, RN, Brazil
| | - Iraci Duarte
- Fundação Nacional de Saúde, Secretaria de Saúde do Estado do Rio Grande do Norte, Natal, RN, Brazil
| | - Selma M B Jeronimo
- Instituto Nacional de Ciência e Tecnologia de Doenças Tropicais, INCT-DT, Brazil ; Department of Biochemistry, Universidade Federal do Rio Grande do Norte, Natal, RN, Brazil ; Health Post-Graduate Program, Universidade Federal do Rio Grande do Norte, Natal, RN, Brazil
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