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Pinnegar HP, Sánchez-Montalvá A, Barios Profitos M, Bosch-Nicolau P, Salvador F, Molina Romero I. Utility of Fluorine-18 Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography in Patients with Visceral Leishmaniasis: Case Report and Literature Review. Am J Trop Med Hyg 2021; 104:934-944. [PMID: 33534763 DOI: 10.4269/ajtmh.19-0858] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Accepted: 07/01/2020] [Indexed: 01/23/2023] Open
Abstract
The diagnosis of visceral leishmaniasis (VL) is complicated and often unsuspected. Little is known of the usefulness of nuclear imaging in VL. Our objective was to describe findings seen in fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) in cases of VL. We retrospectively reviewed VL cases diagnosed at Vall d'Hebron University Hospital from May 2012 to May 2018 and selected those that had an FDG-PET/CT performed. Information on procedures and details of the FDG-PET/CT features and follow-up were collected. We then systematically reviewed the literature on VL and FDG-PET/CT. Four of 43 patients diagnosed with VL had an FDG-PET/CT performed. All four patients presented diffuse splenic uptake of FDG-PET/CT. Adenopathy was not always present, and bone marrow uptake was found in two patients. A posttreatment FDG-PET/CT in one patient revealed normalization of initial findings. In the literature review, 43 of 50 cases presented similar splenic uptake in the PET/CT, being described as different patterns: "increased metabolism," "homogeneous," "diffuse," "diffuse and multifocal," "nodular," "patchy and granular," "subcortical," and "compatible with lymphoma." Other frequent findings were bone marrow uptake and adenopathies. We, therefore, conclude that FDG-PET/CT could become a useful tool for the diagnosis and follow-up of VL and that VL should be taken into account in patients with fever of unknown origin with enhanced splenic uptake in FDG-PET/CT. Differential diagnosis in these cases should be made with splenic primary lymphoma, virus infections, chemotherapy, and colony-stimulating factor therapy. Further structured studies with more cases are needed to define its diagnostic and prognostic value.
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Affiliation(s)
- Harriet P Pinnegar
- 1Department of Infectious Diseases, Vall d'Hebron University Hospital, PROSICS Barcelona, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Adrián Sánchez-Montalvá
- 1Department of Infectious Diseases, Vall d'Hebron University Hospital, PROSICS Barcelona, Universitat Autònoma de Barcelona, Barcelona, Spain.,2Grupo de Estudios de Infecciones por Micobacterias (GEIM), SEIMC, Madrid, Spain
| | - Marta Barios Profitos
- 3Department of Nuclear Medicine, Vall d'Hebron University Hospital, Barcelona, Spain
| | - Pau Bosch-Nicolau
- 1Department of Infectious Diseases, Vall d'Hebron University Hospital, PROSICS Barcelona, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Fernando Salvador
- 1Department of Infectious Diseases, Vall d'Hebron University Hospital, PROSICS Barcelona, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Israel Molina Romero
- 1Department of Infectious Diseases, Vall d'Hebron University Hospital, PROSICS Barcelona, Universitat Autònoma de Barcelona, Barcelona, Spain
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Tesfanchal B, Gebremichail G, Belay G, Gebremariam G, Teklehaimanot G, Haileslasie H, Kahsu G, Gebrewahd A, Mardu F, Adhanom G, Berhe B, Teame H, Tsegaye A, Wolde M. Alteration of Clinical Chemistry Parameters Among Visceral Leishmaniasis Patients in Western Tigrai, Ethiopia, 2018/2019: A Comparative Cross-Sectional Study. Infect Drug Resist 2020; 13:3055-3062. [PMID: 32943889 PMCID: PMC7467734 DOI: 10.2147/idr.s261698] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Accepted: 08/04/2020] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Visceral leishmaniasis causes alterations of lipid metabolism and it is associated with hypocholesterolemia and severe hypertriglyceridemia. Hepatic dysfunction and life-threatening hepatitis are associated with visceral leishmaniasis. Kidney damage is frequently associated with increased morbidity and mortality in visceral leishmaniasis patients. METHODS A cross-sectional study was carried out to assess the alterations of clinical chemistry parameters among visceral leishmaniasis patients attending Kahsay Abera and Mearg hospitals, Northwest Ethiopia. A total of 100 visceral leishmaniasis patients and 100 healthy controls without visceral leishmaniasis were selected by using convenient sampling techniques. Data were entered and analyzed using statistical package for social sciences (SPSS) version 23. RESULTS Results were showed that the mean value of serum aspartate aminotransferase, alanine aminotransferase, alkaline phosphatase, total bilirubin, and triglyceride was significantly higher in visceral leishmaniasis patients than in apparently healthy controls, but the mean value of serum urea and total cholesterol was significantly lower in visceral leishmaniasis patients than healthy controls. CONCLUSION The finding of this study concluded that visceral leishmaniasis causes significant alterations of clinical chemistry tests like liver and lipid profile tests compared to healthy controls.
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Affiliation(s)
- Brhane Tesfanchal
- Unit of Clinical Chemistry, Department of Medical Laboratory Sciences, College of Medicine and Health Sciences, Adigrat University, Adigrat, Ethiopia
| | - Gebremedhin Gebremichail
- Unit of Hematology and Immuno-Hematology, Department of Medical Laboratory Sciences, College of Medicine and Health Sciences, Adigrat University, Adigrat, Ethiopia
| | - Getachew Belay
- Unit of Clinical Chemistry, Department of Medical Laboratory Sciences, College of Medicine and Health Sciences, Adigrat University, Adigrat, Ethiopia
| | - Gebreslassie Gebremariam
- Unit of Clinical Chemistry, Department of Medical Laboratory Sciences, College of Medicine and Health Sciences, Mekelle University, Mekelle, Ethiopia
| | - Gebreyohannes Teklehaimanot
- Unit of Hematology and Immuno-Hematology, Department of Medical Laboratory Sciences, College of Medicine and Health Sciences, Mekelle University, Mekelle, Ethiopia
| | - Hagos Haileslasie
- Unit of Hematology and Immuno-Hematology, Department of Medical Laboratory Sciences, College of Medicine and Health Sciences, Adigrat University, Adigrat, Ethiopia
| | - Getachew Kahsu
- Unit of Clinical Chemistry, Department of Medical Laboratory Sciences, College of Medicine and Health Sciences, Adigrat University, Adigrat, Ethiopia
| | - Aderajew Gebrewahd
- Unit of Medical Microbiology, Department of Medical Laboratory Sciences, College of Medicine and Health Sciences, Adigrat University, Adigrat, Ethiopia
| | - Fitsum Mardu
- Unit of Medical Parasitology and Entomology, Department of Medical Laboratory Science, College of Medicine and Health Science, Adigrat University, Adigrat, Ethiopia
| | - Gebre Adhanom
- Unit of Medical Microbiology, Department of Medical Laboratory Sciences, College of Medicine and Health Sciences, Adigrat University, Adigrat, Ethiopia
| | - Brhane Berhe
- Unit of Medical Parasitology and Entomology, Department of Medical Laboratory Science, College of Medicine and Health Science, Adigrat University, Adigrat, Ethiopia
| | - Hirut Teame
- Department of Public Health, College of Medicine and Health Sciences, Adigrat University, Adigrat, Ethiopia
| | - Aster Tsegaye
- Unit of Hematology and Immuno-Hematology, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Mistire Wolde
- Unit of Clinical Chemistry, College of Medicine and Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
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