title: Hormonal disturbances in visceral leishmaniasis (kala-azar).
abstract: This study presents a cross-sectional analysis of the hormonal alterations of patients with visceral leishmaniasis. The diagnosis was established by the bone marrow aspiration and polymerase chain reaction test. Primary adrenal insufficiency was observed in 45.8% of patients; low aldosterone/renin plasma ratio in 69.4%; low daily urinary aldosterone excretion in 61.1%; and low transtubular potassium gradient in 68.0%. All patients had normal plasma antidiuretic hormone (ADH) concentrations, hyponatremia, and high urinary osmolality. Plasma parathyroid hormone was low in 63%; hypomagnesemia was present in 46.4%, and increased Mg(++)(EF) in 100%. Primary thyroid insufficiency was observed in 24.6%, and secondary thyroid insufficiency in 14.1%. Normal follicle-stimulating hormone plasma levels were present in 81.4%; high luteinizing hormone and low testosterone plasma levels in 58.2% of men. There are evidences of hypothalamus-pituitary-adrenal axis abnormalities, inappropriate aldosterone and ADH secretions, and presence of hypoparathyroidism, magnesium depletion, thyroid and testicular insufficiencies.
authors.affiliation: Instituto de Nefrologia do Ceará, Avenida Rui Barbosa 2992, Fortaleza, Ceará, Brazil. elimaverde@hotmail.com
authors.forename: Frederico Araujo Lima
authors.initials: FA
authors.lastname: Verde
authors.forename: Francisco Agenor Araujo Lima
authors.initials: FA
authors.lastname: Verde
authors.forename: Augusto Saboia
authors.initials: AS
authors.lastname: Neto
authors.forename: Paulo César
authors.initials: PC
authors.lastname: Almeida
authors.forename: Emir Mendonça Lima
authors.initials: EM
authors.lastname: Verde
mesh_terms: D000293:Adolescent; D000328:Adult; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D005260:Female; D006728:Hormones / Q000097:blood*; D006801:Humans; D007898:Leishmaniasis, Visceral / Q000503:physiopathology*; D008297:Male; D016133:Polymerase Chain Reaction; D055815:Young Adult
chemical_list: D006728:Hormones