title: Serum erythropoietin concentration in anaemia of visceral leishmaniasis (kala-azar) before and during antimonial therapy.
abstract: Serum erythropoietin (Epo) concentrations and variables of red cell and iron status were studied in 27 Sudanese patients who were treated with sodium stibogluconate for visceral leishmaniasis (kala-azar). Blood haemoglobin increased from 6.4 (+/- 1.7 SD) to 9.5 (+/- 1.4) g/dl during treatment. Serum ferritin decreased concomitantly. Serum iron levels were unchanged whereas the total iron binding capacity increased slightly. The pre-treatment serum Epo concentration in relation to the blood haemoglobin concentration was not as high as expected from the one in primary haematological diseases, indicating that there is a relative lack of Epo in anaemic kala-azar patients. Serum Epo further decreased during stibogluconate therapy. The normal dependence of the serum Epo level on the blood haemoglobin concentration was lost during mid-term antimonial treatment, but it recovered thereafter. Cell culture studies with the human hepatoma cells HepG2 showed that stibogluconate (> or = 30 microg/ml) inhibited Epo gene expression. Thus, effective treatment of kala-azar with stibogluconate results in improvement of anaemia, although the drug itself may impair Epo production.
authors.affiliation: Department of Physiology, University of Khartoum, Sudan.
authors.forename: A M
authors.initials: AM
authors.lastname: Saeed
authors.forename: E A
authors.initials: EA
authors.lastname: Khalil
authors.forename: A M
authors.initials: AM
authors.lastname: Elhassan
authors.forename: F A
authors.initials: FA
authors.lastname: Hashim
authors.forename: A M
authors.initials: AM
authors.lastname: Elhassan
authors.forename: J
authors.initials: J
authors.lastname: Fandrey
authors.forename: W
authors.initials: W
authors.lastname: Jelkmann
mesh_terms: D000328:Adult; D000967:Antimony Sodium Gluconate / Q000627:therapeutic use*; D000981:Antiprotozoal Agents / Q000627:therapeutic use*; D004921:Erythropoietin / Q000097:blood*; D005260:Female; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D007898:Leishmaniasis, Visceral / Q000097:blood* / Q000188:drug therapy; D008297:Male
chemical_list: D000981:Antiprotozoal Agents; D006454:Hemoglobins; D004921:Erythropoietin; D000967:Antimony Sodium Gluconate