Diabetes Modifies the Clinic Presentation of Cutaneous Leishmaniasis
| Autor: | Neuza Lago, Alexsandro S. Lago, Paulo Roberto Lima Machado, Filipe R Lima, Sérgio Arruda, Luiz Henrique Guimarães, Lucas P. Carvalho, Edgar M. Carvalho, Jamile Lago, Augusto M. Carvalho, Camilla Sampaio |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
0301 basic medicine
medicine.medical_specialty medicine.medical_treatment 030231 tropical medicine Gastroenterology Peripheral blood mononuclear cell immune response tegumentary leishmaniasis Major Articles Lesion cutaneous leishmaniasis 03 medical and health sciences 0302 clinical medicine Cutaneous leishmaniasis Antigen Diabetes mellitus Internal medicine Biopsy Medicine leishmaniasis diabetes medicine.diagnostic_test business.industry Leishmaniasis medicine.disease AcademicSubjects/MED00290 030104 developmental biology Infectious Diseases Cytokine Oncology diabetes mellitus medicine.symptom business |
| Zdroj: | Open Forum Infectious Diseases |
| ISSN: | 2328-8957 |
| DOI: | 10.1093/ofid/ofaa491 |
| Popis: | BackgroundCutaneous leishmaniasis (CL) caused by L. braziliensis is characterized by 1 or multiple well-limited ulcerated lesions. Diabetes mellitus (DM) impairs neutrophil and monocyte function, and there is a report of vegetative lesions in a patient with both diseases in Morocco. Here we evaluate the influence of DM on clinical manifestations, immune response, and in the treatment of CL.MethodsThe participants were 36 DM patients with CL and 36 patients with CL without DM, matched by age and gender. The diagnosis of CL was performed by documentation of DNA of L. braziliensis by polymerase chain reaction in the lesion biopsy and histopathologic findings. All patients were treated with Glucantime (Sanofi-Aventis) 20 mg/kg of weight per day for 20 days.ResultsThere was no difference in the majority of the clinical variables between the groups, and the cure rate in patients with CL and DM (67%) was similar to that observed in CL patients (56%; P ˃ .05). The most important finding was the documentation that 36% of the patients with DM and CL had atypical cutaneous lesions characterized by large superficial ulcers without defined borders. High levels of interferon-γ, tumor necrosis facor, and interleukin-1β were detected in the supernatants of mononuclear cells stimulated with Leishmania antigen in patients with DM and atypical CL. Moreover, while cure was observed in only 33% of the patients with DM and atypical CL lesions, it was observed in 85% of patients with typical lesions (P ConclusionsDM modifies the clinical presentation of CL, enhances pro-inflammatory cytokine production, and impairs response to antimony therapy. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|