title: [Liver injury in visceral leishmaniasis in children: systematic review].
abstract: Visceral Leisshimaniosis or Kalazar is a parasitic infection caused by Leishimania Donovani subspecies. It is transmitted by phlebotomineos and may lead to liver and spleen enlargements as well as immunological impairment. Sometimes it is described liver injury simulating acute or chronic viral hepatitis and even portal hypertension. The liver injury makes difficult the diffencial diagnosis of Kalazar and other liver diseases in endemic regions.
  
  
  OBJECTIVE
  To define and clarify the liver injury spectrum described in published cases reports.
  
  
  METHODS
  Systematic revision of published data on Kalazar and liver injury using the following databank: LILACS, MEDLINE and EMBASE. Only paper published in French, English, Portuguese and Spanish were taken into consideration. The procedures for systematic review recommended by the NHS Centre for Reviews and Dissemination, University of Cork, were adopted. The paper quality classification was based on the number of reported variables previously defined in our study
  
  
  RESULTS
  Only 11/28 (55%) publications were included in our analysis because they filled the minimal required data. Acute and chronic liver disease were well documented in these articles. Serum albumin and prothombine time were associated with severity of liver disease (P < .05).
  
  
  CONCLUSIONS
  "Liver involvement, even when it is severe, may occur at tha begining of the disease. Kalazar should be considered as a differential diagnosis of cholestasis, acute and chronic liver injury as well as portal hypertension in children.
authors.affiliation: Hospital Universitario Alcides Carneiro de la Universidad Federal de Campina Grande, Brasil.
authors.forename: Francisco Salomao de
authors.initials: FS
authors.lastname: Medeiros
authors.forename: Jose
authors.initials: J
authors.lastname: Tavares-Neto
authors.forename: Argemiro
authors.initials: A
authors.lastname: D'Oliveira
authors.forename: Raymundo
authors.initials: R
authors.lastname: Paraná
mesh_terms: D000293:Adolescent; D015415:Biomarkers / Q000097:blood; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007898:Leishmaniasis, Visceral / Q000097:blood / Q000150:complications* / Q000175:diagnosis; D008099:Liver / Q000469:parasitology / Q000473:pathology; D008109:Liver Diseases, Parasitic / Q000097:blood / Q000175:diagnosis / Q000209:etiology*; D008297:Male; D011516:Prothrombin / Q000032:analysis; D012709:Serum Albumin / Q000032:analysis; D012720:Severity of Illness Index
chemical_list: D015415:Biomarkers; D012709:Serum Albumin; D011516:Prothrombin