title: Immune reconstitution visceral leishmaniasis presented as hemophagocytic syndrome in a patient with AIDS from a nonendemic area: a case report.
abstract: Visceral Leishmaniasis (VL) is endemic in the Ganges and Brahmaputra plains of India. Leishmaniasis/HIV coinfection is on the rise in India and may pose a real diagnostic and therapeutic challenge. HIV-related immunosuppression increases the risk of reactivating leishmaniasis by 100 to 1000 times and it also increases the risk of drug resistant leishmaniasis. Immune reconstitution VL is not very well reported in literature. Hemophagocytosis is known to occur with various infectious agents like viruses, bacteria, and parasites, but is rare to occur with leishmaniasis. Here the authors describe a case of VL presenting as immune reconstitution disease and hemophagocytosis in an HIV infected patient coming from a nonendemic area.
authors.affiliation: Infectious Diseases Clinic, VEDANTA Institute of Medical Sciences, Navrangpura, Ahmedabad, Gujarat, India. ketankpatel20@hotmail.com
authors.forename: Ketan K
authors.initials: KK
authors.lastname: Patel
authors.forename: Atul K
authors.initials: AK
authors.lastname: Patel
authors.forename: Parimal
authors.initials: P
authors.lastname: Sarda
authors.forename: Bhavin A
authors.initials: BA
authors.lastname: Shah
authors.forename: Rajiv
authors.initials: R
authors.lastname: Ranjan
mesh_terms: D000328:Adult; D000740:Anemia / Q000209:etiology; D001853:Bone Marrow / Q000469:parasitology / Q000473:pathology; D018791:CD4 Lymphocyte Count; D005293:Ferritins / Q000097:blood; D005334:Fever / Q000209:etiology; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D015228:Hypertriglyceridemia / Q000209:etiology; D054019:Immune Reconstitution Inflammatory Syndrome / Q000209:etiology*; D007898:Leishmaniasis, Visceral / Q000175:diagnosis*; D051359:Lymphohistiocytosis, Hemophagocytic / Q000209:etiology*; D008297:Male; D013163:Splenomegaly / Q000209:etiology; D015431:Weight Loss
chemical_list: D005293:Ferritins