Pancreatic involvement in co-infection visceral leishmaniasis and HIV: histological and ultrastructural aspects

The involvement of the gastrointestinal tract in the co-infection of HIV and Leishmania is rarely reported. We report the case of an HIV-infected adult man co-infected with a disseminated form of leishmaniasis involving the liver, lymph nodes, spleen and, as a feature reported for the first time in...

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Published in:Revista do Instituto de Medicina Tropical de São Paulo 2001-03, Vol.43 (2), p.75-78
Main Authors: Chehter, E Z, Longo, M A, Laudanna, A A, Duarte, M I
Format: Article
Language:English
Subjects:
Adult
AIDS
AIDS-Related Opportunistic Infections - complications
AIDS-Related Opportunistic Infections - pathology
Fatal Outcome
HIV Infections - complications
HIV Infections - pathology
Humans
Leishmaniasis, Visceral - complications
Leishmaniasis, Visceral - pathology
Male
Malnutrition
Opportunistic infection
Pancreas
Pancreatic Diseases - complications
Pancreatic Diseases - pathology
Protein-Energy Malnutrition - etiology
TROPICAL MEDICINE
Visceral Leishmaniasis
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Summary:The involvement of the gastrointestinal tract in the co-infection of HIV and Leishmania is rarely reported. We report the case of an HIV-infected adult man co-infected with a disseminated form of leishmaniasis involving the liver, lymph nodes, spleen and, as a feature reported for the first time in the English literature, the pancreas. Light microscopy showed amastigote forms of Leishmania in pancreatic macrophages and immunohistochemical staining revealed antigens for Leishmania and also for HIV p24. Microscopic and ultrastructural analysis revealed severe acinar atrophy, decreased zymogen granules in the acinar cytoplasm and also nuclear abnormalities such as pyknosis, hyperchromatism and thickened chromatin. These findings might correspond to the histologic pattern of protein-energy malnutrition in the pancreas as shown in our previous study in pancreas with AIDS and no Leishmania. In this particular case, the protein-energy malnutrition may be due to cirrhosis, or, Leishmania or HIV infection or all mixed. We believe that this case represents the morphologic substratum of the protein energy malnutrition in pancreas induced by the HIV infection. Further studies are needed to elucidate these issues.
ISSN:0036-4665
1678-9946
0036-4665
1678-9946
DOI:10.1590/S0036-46652001000200004