title: Disease Severity Prediction by Spirometry in Adults with Visceral Leishmaniasis from Minas Gerais, Brazil.
abstract: Visceral leishmaniasis (VL) is associated with interstitial pneumonitis according to histology and radiology reports. However, studies to address the functional impact on respiratory function in patients are lacking. We assessed pulmonary function using noninvasive spirometry in a cross-sectional study of hospitalized adult VL patients from Minas Gerais, Brazil, without unrelated lung conditions or acute infections. Lung conditions were graded as normal, restrictive, obstructive, or mixed patterns, according to Brazilian consensus standards for spirometry. To control for regional patterns of lung function, we compared spirometry of patients with regional paired controls. Spirometry detected abnormal lung function in most VL patients (70%, 14/20), usually showing a restrictive pattern, in contrast to regional controls and the standards for normal tests. Alterations in spirometry measurements correlated with hypoalbuminemia, the only laboratory value indicative of severity of parasitic disease. Abnormalities did not correlate with unrelated factors such as smoking or occupation. Clinical data including pulmonary symptoms and duration of therapy were also unrelated to abnormal spirometry findings. We conclude that the severity of VL is correlated with a restrictive pattern of lung function according to spirometry, suggesting that there may be interstitial lung involvement in VL. Further studies should address whether spirometry could serve as an index of disease severity in the management of VL.
authors.affiliation: Department of Infectious and Parasitic Diseases, Faculty of Medicine, University of São Paulo, São Paulo, Brazil. isabel.aragao@usp.br.
authors.forename: Isabel A
authors.initials: IA
authors.lastname: Maia
authors.affiliation: Laboratory of Experimental Pathophysiology (LAFEx), Department of Biological Sciences (DECBI), Center of Research in Biological Sciences (NUPEB), Federal University of Ouro Preto (UFOP), Ouro Preto, Brazil.
authors.forename: Frank S
authors.initials: FS
authors.lastname: Bezerra
authors.affiliation: Pneumology Division, Heart Institute, Hospital das Clínicas da Universidade de São Paulo (HCFMUSP), São Paulo, Brazil.
authors.forename: André Luis Pereira de
authors.initials: AL
authors.lastname: Albuquerque
authors.affiliation: Laboratory of Protozoology, Instituto de Medicina Tropical de Sao Paulo (IMTSP), Universidade de São Paulo, São Paulo, Brazil.|Department of Pathology, Faculty of Medicine, University of São Paulo (FMUSP), São Paulo, Brazil.
authors.forename: Heitor F
authors.initials: HF
authors.lastname: Andrade
authors.affiliation: Department of Infectious and Parasitic Diseases, Faculty of Medicine, University of São Paulo, São Paulo, Brazil.
authors.forename: Antonio C
authors.initials: AC
authors.lastname: Nicodemo
authors.affiliation: Department of Infectious and Parasitic Diseases, Faculty of Medicine, University of São Paulo, São Paulo, Brazil.
authors.forename: Valdir S
authors.initials: VS
authors.lastname: Amato
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001938:Brazil; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007898:Leishmaniasis, Visceral / Q000175:diagnosis* / Q000503:physiopathology; D008168:Lung / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D012129:Respiratory Function Tests; D013147:Spirometry / Q000379:methods; D055815:Young Adult