title: Glomerulonephritis and cryoglobulinemia: first manifestation of visceral leishmaniasis.
abstract: Visceral leishmaniasis due to Leishmania Infantum is an endemic parasitic infection in the Mediterranean area. Since 2009, Europe's largest outbreak of Leishmaniasis has been reported in the region of Madrid (Spain). Renal involvement is an unusual complication. Different forms of renal disease have been described: interstitial, glomerular, and vascular damage. Direct invasion of renal parenchyma by the parasite has been described as a mechanism of kidney damage, especially in the immunocompromised. Immune complex deposition and T cells adhesion molecules activation have demonstrated that a pathogenic role in glomerulonephritis related to visceral leishmaniasis. The association between mixed cryoglobulinemia and visceral leishmaniasis has been previously reported in six patients. Renal involvement is only described in one of them. From July 2009 to October 2012, 4 patients with membranoproliferative glomerulonephritis and mixed cryoglobulinemia with negative serology for hepatitis B and C were diagnosed in our hospital. Serology of Leishmania in serum bank samples was performed; it was positive in 3 patients. Leishmania parasite was confirmed by other tests. We present 3 patients with mixed cryoglobulinemia and membranoproliferative glomerulonephritis as first clinical manifestation of visceral leishmaniasis.
authors.forename: Milagros
authors.initials: M
authors.lastname: Ortiz
authors.forename: Carmen
authors.initials: C
authors.lastname: Mon
authors.forename: Juan Carlos
authors.initials: JC
authors.lastname: Herrero
authors.forename: Aniana
authors.initials: A
authors.lastname: Oliet
authors.forename: Isabel
authors.initials: I
authors.lastname: Rodríguez
authors.forename: Olimpia
authors.initials: O
authors.lastname: Ortega
authors.forename: Paloma
authors.initials: P
authors.lastname: Gallar
authors.forename: Julie
authors.initials: J
authors.lastname: Hinostroza
authors.forename: Gabriela
authors.initials: G
authors.lastname: Cobo
authors.forename: Manuel
authors.initials: M
authors.lastname: del Alamo
authors.forename: Juana
authors.initials: J
authors.lastname: Jiménez
authors.forename: Rafael
authors.initials: R
authors.lastname: Torres
authors.forename: Cristina
authors.initials: C
authors.lastname: Digiogia
authors.forename: Juan
authors.initials: J
authors.lastname: San Martin
authors.forename: Ana I
authors.initials: AI
authors.lastname: Vigil
authors.forename: Julia
authors.initials: J
authors.lastname: Blanco
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003449:Cryoglobulinemia / Q000209:etiology*; D005921:Glomerulonephritis / Q000209:etiology*; D015432:Glomerulonephritis, Membranoproliferative / Q000209:etiology; D006801:Humans; D018314:Leishmania infantum / Q000302:isolation & purification; D007898:Leishmaniasis, Visceral / Q000150:complications*; D008297:Male; D008875:Middle Aged