title: Treatment of atypical leishmaniasis with interferon gamma resulting in progression of Kaposi's sarcoma in an AIDS patient.
abstract: 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.
authors.affiliation: Medizinische Kernklinik und Poliklinik, Universitätskrankenhaus Eppendorf, Hamburg, Germany.
authors.forename: H
authors.initials: H
authors.lastname: Albrecht
authors.forename: H J
authors.initials: HJ
authors.lastname: Stellbrink
authors.forename: G
authors.initials: G
authors.lastname: Gross
authors.forename: B
authors.initials: B
authors.lastname: Berg
authors.forename: U
authors.initials: U
authors.lastname: Helmchen
authors.forename: H
authors.initials: H
authors.lastname: Mensing
mesh_terms: 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*
chemical_list: D007371:Interferon-gamma