Is severe visceral leishmaniasis a systemic inflammatory response syndrome? A case control study

Detalhes bibliográficos
Autor(a) principal: Costa,Carlos Henrique Nery
Data de Publicação: 2010
Outros Autores: Werneck,Guilherme Loureiro, Costa,Dorcas Lamounier, Holanda,Thiago Ayres, Aguiar,Guilherme Brasileiro, Carvalho,Aline Santos, Cavalcanti,Janaína Costa, Santos,Loryenne Santos
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Revista da Sociedade Brasileira de Medicina Tropical
Texto Completo: http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0037-86822010000400010
Resumo: INTRODUCTION: The objective of the study is to identify the main risk factors for death by New World visceral leishmaniasis and establish a coherent pathogenic substrate of severe disease based on clinical findings. METHODS: Seventy-six deceased inpatients and 320 successfully treated inpatients with VL were studied in a case control study. RESULTS: Bacterial infection and bleeding were mutually exclusive events leading to death. Five risk factors were unique for death by bacterial infection (malnutrition, pulmonary rales, severe anemia, severe absolute neutropenia and higher neutrophil count), while another six were unique for death by bleeding (jaundice, severe relative neutropenia, severe thrombocytopenia, liver injury, kidney failure, higher bone marrow parasite load). Bacterial infection, bleeding, severe anemia, diarrhea, dyspnea, edema, jaundice and bone marrow parasite load were the main syndromes of visceral leishmaniasis among successfully treated patients. CONCLUSIONS: The data support the idea that bacterial infections are due to immune paralysis. Broad organ and system involvement is plausibly due to the high production of proinflammatory cytokines, whose actions fit well with visceral leishmaniasis. The syndromes and causative mediators are typical of a slowly developing systemic inflammatory response syndrome.
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spelling Is severe visceral leishmaniasis a systemic inflammatory response syndrome? A case control studyVisceral leishmaniasisKala-azarSevere inflammatory response syndromeAIDSBleedingINTRODUCTION: The objective of the study is to identify the main risk factors for death by New World visceral leishmaniasis and establish a coherent pathogenic substrate of severe disease based on clinical findings. METHODS: Seventy-six deceased inpatients and 320 successfully treated inpatients with VL were studied in a case control study. RESULTS: Bacterial infection and bleeding were mutually exclusive events leading to death. Five risk factors were unique for death by bacterial infection (malnutrition, pulmonary rales, severe anemia, severe absolute neutropenia and higher neutrophil count), while another six were unique for death by bleeding (jaundice, severe relative neutropenia, severe thrombocytopenia, liver injury, kidney failure, higher bone marrow parasite load). Bacterial infection, bleeding, severe anemia, diarrhea, dyspnea, edema, jaundice and bone marrow parasite load were the main syndromes of visceral leishmaniasis among successfully treated patients. CONCLUSIONS: The data support the idea that bacterial infections are due to immune paralysis. Broad organ and system involvement is plausibly due to the high production of proinflammatory cytokines, whose actions fit well with visceral leishmaniasis. The syndromes and causative mediators are typical of a slowly developing systemic inflammatory response syndrome.Sociedade Brasileira de Medicina Tropical - SBMT2010-08-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S0037-86822010000400010Revista da Sociedade Brasileira de Medicina Tropical v.43 n.4 2010reponame:Revista da Sociedade Brasileira de Medicina Tropicalinstname:Sociedade Brasileira de Medicina Tropical (SBMT)instacron:SBMT10.1590/S0037-86822010000400010info:eu-repo/semantics/openAccessCosta,Carlos Henrique NeryWerneck,Guilherme LoureiroCosta,Dorcas LamounierHolanda,Thiago AyresAguiar,Guilherme BrasileiroCarvalho,Aline SantosCavalcanti,Janaína CostaSantos,Loryenne Santoseng2010-08-17T00:00:00Zoai:scielo:S0037-86822010000400010Revistahttps://www.sbmt.org.br/portal/revista/ONGhttps://old.scielo.br/oai/scielo-oai.php||dalmo@rsbmt.uftm.edu.br|| rsbmt@rsbmt.uftm.edu.br1678-98490037-8682opendoar:2010-08-17T00:00Revista da Sociedade Brasileira de Medicina Tropical - Sociedade Brasileira de Medicina Tropical (SBMT)false
dc.title.none.fl_str_mv Is severe visceral leishmaniasis a systemic inflammatory response syndrome? A case control study
title Is severe visceral leishmaniasis a systemic inflammatory response syndrome? A case control study
spellingShingle Is severe visceral leishmaniasis a systemic inflammatory response syndrome? A case control study
Costa,Carlos Henrique Nery
Visceral leishmaniasis
Kala-azar
Severe inflammatory response syndrome
AIDS
Bleeding
title_short Is severe visceral leishmaniasis a systemic inflammatory response syndrome? A case control study
title_full Is severe visceral leishmaniasis a systemic inflammatory response syndrome? A case control study
title_fullStr Is severe visceral leishmaniasis a systemic inflammatory response syndrome? A case control study
title_full_unstemmed Is severe visceral leishmaniasis a systemic inflammatory response syndrome? A case control study
title_sort Is severe visceral leishmaniasis a systemic inflammatory response syndrome? A case control study
author Costa,Carlos Henrique Nery
author_facet Costa,Carlos Henrique Nery
Werneck,Guilherme Loureiro
Costa,Dorcas Lamounier
Holanda,Thiago Ayres
Aguiar,Guilherme Brasileiro
Carvalho,Aline Santos
Cavalcanti,Janaína Costa
Santos,Loryenne Santos
author_role author
author2 Werneck,Guilherme Loureiro
Costa,Dorcas Lamounier
Holanda,Thiago Ayres
Aguiar,Guilherme Brasileiro
Carvalho,Aline Santos
Cavalcanti,Janaína Costa
Santos,Loryenne Santos
author2_role author
author
author
author
author
author
author
dc.contributor.author.fl_str_mv Costa,Carlos Henrique Nery
Werneck,Guilherme Loureiro
Costa,Dorcas Lamounier
Holanda,Thiago Ayres
Aguiar,Guilherme Brasileiro
Carvalho,Aline Santos
Cavalcanti,Janaína Costa
Santos,Loryenne Santos
dc.subject.por.fl_str_mv Visceral leishmaniasis
Kala-azar
Severe inflammatory response syndrome
AIDS
Bleeding
topic Visceral leishmaniasis
Kala-azar
Severe inflammatory response syndrome
AIDS
Bleeding
description INTRODUCTION: The objective of the study is to identify the main risk factors for death by New World visceral leishmaniasis and establish a coherent pathogenic substrate of severe disease based on clinical findings. METHODS: Seventy-six deceased inpatients and 320 successfully treated inpatients with VL were studied in a case control study. RESULTS: Bacterial infection and bleeding were mutually exclusive events leading to death. Five risk factors were unique for death by bacterial infection (malnutrition, pulmonary rales, severe anemia, severe absolute neutropenia and higher neutrophil count), while another six were unique for death by bleeding (jaundice, severe relative neutropenia, severe thrombocytopenia, liver injury, kidney failure, higher bone marrow parasite load). Bacterial infection, bleeding, severe anemia, diarrhea, dyspnea, edema, jaundice and bone marrow parasite load were the main syndromes of visceral leishmaniasis among successfully treated patients. CONCLUSIONS: The data support the idea that bacterial infections are due to immune paralysis. Broad organ and system involvement is plausibly due to the high production of proinflammatory cytokines, whose actions fit well with visceral leishmaniasis. The syndromes and causative mediators are typical of a slowly developing systemic inflammatory response syndrome.
publishDate 2010
dc.date.none.fl_str_mv 2010-08-01
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dc.language.iso.fl_str_mv eng
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dc.publisher.none.fl_str_mv Sociedade Brasileira de Medicina Tropical - SBMT
publisher.none.fl_str_mv Sociedade Brasileira de Medicina Tropical - SBMT
dc.source.none.fl_str_mv Revista da Sociedade Brasileira de Medicina Tropical v.43 n.4 2010
reponame:Revista da Sociedade Brasileira de Medicina Tropical
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repository.name.fl_str_mv Revista da Sociedade Brasileira de Medicina Tropical - Sociedade Brasileira de Medicina Tropical (SBMT)
repository.mail.fl_str_mv ||dalmo@rsbmt.uftm.edu.br|| rsbmt@rsbmt.uftm.edu.br
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