Treatment of atypical leishmaniasis with interferon gamma resulting in progression of Kaposi's sarcoma in an AIDS patient.
Visceral leishmaniasis (kala-azar) affecting HIV-infected patient is being reported in increasing frequency. A 40-year-old German bisexual patient with full-blown AIDS is described who presented with Kaposi's sarcoma, epigastric pain, diarrhea, and weight loss but without fever. Leishmania amastigotes were initially found in biopsies from stomach, duodenum, and a cutaneous Kaposi's sarcoma lesion but were later also recovered from bone marrow and lymph node. The patient received three courses of a combination of pentavalent antimony and interferon-gamma. In addition to the common side effects such as fever, thrombocytopenia, and elevated amylase and lipase, a vivid progression of the Kaposi's sarcoma was noted. Tumor progression was temporally closely associated with treatment with interferon-gamma. Because this phenomenon has also been observed in other patients, we advise caution when using interferon-gamma in patients with Kaposi's sarcoma.
Albrecht
H
H
Medizinische Kernklinik und Poliklinik, Universitätskrankenhaus Eppendorf, Hamburg, Germany.
Stellbrink
H J
HJ
Gross
G
G
Berg
B
B
Helmchen
U
U
Mensing
H
H
D000163:Acquired Immunodeficiency Syndrome / Q000150:complications*; D000328:Adult; D006801:Humans; D007371:Interferon-gamma / Q000009:adverse effects*; D007898:Leishmaniasis, Visceral / Q000150:complications / Q000628:therapy*; D008297:Male; D012514:Sarcoma, Kaposi / Q000209:etiology*
D007371:Interferon-gamma