title: Visceral leishmaniasis in adults with nephropathy.
abstract: The aim of this study is to evaluate the features of visceral leishmaniasis (VL) in adults with nephropathy, who were not infected with the human immunodeficiency virus. This is a retrospective study of 14 adults hospitalized between 2000 and 2014, with VL and renal involvement. Clinical, biological, and therapeutic data were collected from the patients' medical files. Eleven women and three men, most of whom were from the North of the country, with a mean age of 40.5 years were studied. Lupus was present in five cases, the Sicca syndrome in three cases, diabetes in one case, renal failure on dialysis in two cases, and there were three renal transplant recipients. Major clinical symptoms were fever and weakness in all cases. Enlargement of the spleen was present in eight cases and hepatomegaly in six cases. Biologic inflammatory syndrome and anemia were present in all cases, and pancytopenia was present in seven cases. Renal insufficiency was noted in all cases. Diagnosis of VL was confirmed by bone marrow examination or serology. Treatment consisted of antimoniate in 10 cases and amphotericin B in four cases. Seven deaths were recorded. Clinical symptoms of VL are atypical in patients with nephropathy and therefore, the diagnosis should be suspected in such patients because VL is still endemic in our country.
authors.affiliation: Department of Medicine A, Charles Nicolle Hospital; Faculty of Medicine, Tunis El Manar University, Tunis, Tunisia.
authors.forename: H Kaaroud
authors.initials: HK
authors.lastname: El Jeri
authors.affiliation: Department of Medicine A, Charles Nicolle Hospital; Faculty of Medicine, Tunis El Manar University, Tunis, Tunisia.
authors.forename: A
authors.initials: A
authors.lastname: Harzallah
authors.affiliation: Department of Medicine A, Charles Nicolle Hospital; Faculty of Medicine, Tunis El Manar University, Tunis, Tunisia.
authors.forename: S
authors.initials: S
authors.lastname: Barbouch
authors.affiliation: Department of Medicine A, Charles Nicolle Hospital; Faculty of Medicine, Tunis El Manar University, Tunis, Tunisia.
authors.forename: M M
authors.initials: MM
authors.lastname: Bacha
authors.affiliation: Department of Nephrology, La Rabta Hospital; Faculty of Medicine, Tunis El Manar University, Tunis, Tunisia.
authors.forename: R
authors.initials: R
authors.lastname: Kheder
authors.affiliation: Department of Medicine A, Charles Nicolle Hospital; Faculty of Medicine, Tunis El Manar University, Tunis, Tunisia.
authors.forename: S
authors.initials: S
authors.lastname: Turki
authors.affiliation: Department of Parasitology, Charles Nicolle Hospital; Faculty of Medicine, Tunis El Manar University, Tunis, Tunisia.
authors.forename: S
authors.initials: S
authors.lastname: Trabelsi
authors.affiliation: Department of Medicine A, Charles Nicolle Hospital; Faculty of Medicine, Tunis El Manar University, Tunis, Tunisia.
authors.forename: E
authors.initials: E
authors.lastname: Abderrahim
authors.affiliation: Laboratory of Renal Pathology LR00SP01, Charles Nicolle Hospital; Faculty of Medicine, Tunis El Manar University, Tunis, Tunisia.
authors.forename: F Ben
authors.initials: FB
authors.lastname: Hamida
authors.affiliation: Department of Medicine A, Charles Nicolle Hospital; Faculty of Medicine, Tunis El Manar University, Tunis, Tunisia.
authors.forename: T Ben
authors.initials: TB
authors.lastname: Abdallah
mesh_terms: D000293:Adolescent; D000328:Adult; D000666:Amphotericin B / Q000627:therapeutic use; D000981:Antiprotozoal Agents / Q000627:therapeutic use; D019353:Endemic Diseases; D005260:Female; D006801:Humans; D016867:Immunocompromised Host; D007674:Kidney Diseases / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D007898:Leishmaniasis, Visceral / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology* / Q000469:parasitology; D008297:Male; D000077485:Meglumine Antimoniate / Q000627:therapeutic use; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D014416:Tunisia / Q000453:epidemiology; D055815:Young Adult
chemical_list: D000981:Antiprotozoal Agents; D000077485:Meglumine Antimoniate; D000666:Amphotericin B