title: Epidemiologic, clinical, diagnostic and therapeutic aspects of visceral leishmaniasis in renal transplant recipients: experience from thirty cases.
abstract: BACKGROUND
  Visceral leishmaniasis is a disease caused by the protozoan Leishmania sp. and is transmitted by Lutzomyia longipalpis (sand fly). In renal transplant recipients, visceral leishmaniasis causes severe damage to the liver, spleen, and hematopoietic system, as well as poor outcomes for patients with transplanted kidneys. This study describes the largest series of cases of visceral leishmaniasis in renal transplant recipients, providing important information about the diagnostic routines and therapeutic strategies in this patient population.
  
  
  METHODS
  A retrospective, descriptive study was performed to analyze the distribution and evaluate the extent of the epidemiologic, clinical, diagnostic and therapeutic aspects of 30 renal transplant recipients from endemic regions who presented with visceral leishmaniasis in the post-transplantation period.
  
  
  RESULTS
  In this study, visceral leishmaniasis was more frequent in men (80%). The mean age of presentation was 40 ± 10.5 years. The majority of patients worked in urban areas (66.7%), cohabitated with domestic animals (90%), and were from low-income households. In 73.3% of cases, diagnosis was made by direct isolation of Leishmania forms. Patients were treated with liposomal amphotericin, resulting in a high degree of disease remission (80%).
  
  
  CONCLUSIONS
  This study describes the largest series of visceral leishmaniasis in renal transplant recipients and expands clinical-epidemiological knowledge for transplantation teams to perform adequate disease management for this specific patient population.
authors: Avelar Alves
authors: AA
authors: de Silva
authors: Álvaro
authors: Á
authors: Pacheco e Silva Filho
authors: Ricardio de Castro Cinta
authors: Rde C
authors: Sesso
authors: Ronaldo de Matos
authors: Rde M
authors: Esmeraldo
authors: Cláudia Maria Costa
authors: CM
authors: de Oliveira
authors: Paula Frassinetti
authors: PF
authors: Fernandes
authors: Rodrigo Alves
authors: RA
authors: de Oliveira
authors: Leila Silveira Veira
authors: LS
authors: de Silva
authors: Valencio Pereira
authors: VP
authors: de Carvalho
authors: Carlos Henrique Nery
authors: CH
authors: Costa
authors: Jesusmar Ximenes
authors: JX
authors: Andrade
authors: Diana Marisa Barros
authors: DM
authors: da Silva
authors: Roosevelt Valente
authors: RV
authors: Chaves
mesh_terms: D000328:Adult; D017677:Age Distribution; D000666:Amphotericin B / Q000627:therapeutic use*; D000818:Animals; D000829:Animals, Domestic; D000981:Antiprotozoal Agents / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D016867:Immunocompromised Host; D007166:Immunosuppressive Agents / Q000009:adverse effects*; D007674:Kidney Diseases / Q000139:chemically induced / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology; D016030:Kidney Transplantation; D007891:Leishmania / Q000302:isolation & purification; D007898:Leishmaniasis, Visceral / Q000139:chemically induced / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*; D008107:Liver Diseases / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology / Q000209:etiology; D008297:Male; D008875:Middle Aged; D012111:Residence Characteristics; D012189:Retrospective Studies; D017678:Sex Distribution; D013158:Splenic Diseases / Q000139:chemically induced / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology; D066027:Transplant Recipients
chemical_list: D000981:Antiprotozoal Agents; D007166:Immunosuppressive Agents; C068538:liposomal amphotericin B; D000666:Amphotericin B