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AA-amyloidosis caused by visceral leishmaniasis in a human immunodeficiency virus-infected patient

de Vallière, Serge and Mary, Charles and Joneberg, Jeanna E. and Rotman, Samuel and Bullani, Roberto and Greub, Gilbert and Gillmore, Julian D. and Buffet, Pierre A. and Tarr, Philip E.. (2009) AA-amyloidosis caused by visceral leishmaniasis in a human immunodeficiency virus-infected patient. American journal of tropical medicine and hygiene, Vol. 81. pp. 209-212.

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Official URL: http://edoc.unibas.ch/dok/A6006265

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Abstract

AA-amyloidosis in the setting of chronic visceral leishmaniasis (VL) has been reported in animal models but documentation in humans is unavailable. Here, we report on a Portuguese man who in 1996 was diagnosed with both human immunodeficiency virus (HIV)-infection and VL. Antiretroviral treatment led to sustained suppression of HIV viremia but CD4+ lymphocytes rose from 8 to only 160 cells/mL. Several courses of antimony treatment did not prevent VL relapses. Renal failure developed in 2006 and renal biopsy revealed AA-amyloidosis. The patient had cryoglobulinemia and serum immune complexes containing antibodies directed against seven leishmanial antigens. Antimony plus amphotericin B, followed by oral miltefosine resulted in a sustained VL treatment response with elimination of circulating Leishmania infantum DNA and CD4+ recovery. The concomitant reduction of serum AA levels and disappearance of circulating leishmanial immune complexes suggests that prolonged VL may lead to AA-amyloidosis in immunocompromised humans.
Faculties and Departments:03 Faculty of Medicine > Bereich Medizinische Fächer (Klinik) > Ehemalige Einheiten Medizinische Fächer (Klinik) > Allgemeine innere Medizin Bruderholz (Krapf)
03 Faculty of Medicine > Departement Klinische Forschung > Bereich Medizinische Fächer (Klinik) > Ehemalige Einheiten Medizinische Fächer (Klinik) > Allgemeine innere Medizin Bruderholz (Krapf)
UniBasel Contributors:Tarr, Philip
Item Type:Article, refereed
Article Subtype:Research Article
Bibsysno:Link to catalogue
Publisher:Williams and Wilkins
ISSN:0002-9637
Note:Publication type according to Uni Basel Research Database: Journal article
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Last Modified:24 May 2013 09:21
Deposited On:24 May 2013 09:00

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