title: Membranoproliferative glomerulonephritis due to visceral leishmaniasis in an HIV patient.
abstract: BACKGROUND
  Visceral leishmaniasis is an important opportunistic disease in HIV-positive patients. The information available on the effects of such co-infection in the kidney is limited. We describe a patient with HIV/leishmania coinfection who developed nephrotic syndrome and membranoproliferative glomerulonephritis. As far as we know, only 2 cases of this nephropathy in HIV/leishmania coinfection have been reported.
  
  
  METHODS
  A 47-year-old man developed nephrotic syndrome. He had been diagnosed with HIV infection and visceral leishmaniasis and was treated with antiretroviral therapy, antimonial compounds, liposomal amphotericin B and miltefosine, but the leishmania followed a relapsing course. Renal biopsy disclosed membranoproliferative glomerulonephritis and leishmania amastigotes were seen within glomerular capillary lumens. He was given miltefosine and liposomal amphotericin B but the leishmaniasis persisted. Stage 3B chronic renal disease and nephrotic range proteinuria tend to become stable by 15-month follow-up.
  
  
  CONCLUSIONS
  Our case illustrated some aspects of leishmaniasis in HIV patients: its relapsing course, the difficulties in therapy, and the renal involvement.
authors.affiliation: Nephrology Section, Hospital General Universitario de Elche, Elche, Spain.
authors.forename: Ricardo
authors.initials: R
authors.lastname: Enríquez
authors.affiliation: Nephrology Section, Hospital General Universitario de Elche, Elche, Spain.
authors.forename: Ana Esther
authors.initials: AE
authors.lastname: Sirvent
authors.affiliation: Infectious Diseases Unit, Hospital General Universitario de Elche, Elche, Spain.
authors.forename: Sergio
authors.initials: S
authors.lastname: Padilla
authors.affiliation: Pathology Section, Hospital General Universitario de Elche, Elche, Spain.
authors.forename: Paula
authors.initials: P
authors.lastname: Toro
authors.affiliation: Nephrology Section, Hospital General Universitario de Elche, Elche, Spain.
authors.forename: María
authors.initials: M
authors.lastname: Sánchez
authors.affiliation: Nephrology Section, Hospital General Universitario de Elche, Elche, Spain.
authors.forename: Isabel
authors.initials: I
authors.lastname: Millán
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000150:complications* / Q000821:virology; D001706:Biopsy; D003937:Diagnosis, Differential; D015432:Glomerulonephritis, Membranoproliferative / Q000175:diagnosis / Q000209:etiology*; D006678:HIV; D006801:Humans; D007678:Kidney Glomerulus / Q000473:pathology*; D007898:Leishmaniasis, Visceral / Q000150:complications* / Q000175:diagnosis; D008297:Male; D008875:Middle Aged