Recurrence of kala‐azar after PKDL: role of co‐factors

Recurrence of kala‐azar after post kala‐azar dermal leishmaniasis (PKDL) has remained uncommon. We report here two patients with recurrence of kala‐azar (KA) after development of PKDL. In one case the second attack of KA was preceded by repeated attacks of malaria and tuberculosis, and in the other...

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Bibliographic Details
Published in:Tropical medicine & international health 1998-01, Vol.3 (1), p.76-78
Main Authors: Nandy, A., Addy, M., Maji, A. K., Guha, S. K., Banerjee, D., Chaudhuri, D.
Format: Article
Language:English
Subjects:
Adolescent
Biological and medical sciences
Child
co‐factors
Human protozoal diseases
Humans
Immune Tolerance
Infectious diseases
Leishmaniasis, Cutaneous - complications
Leishmaniasis, Cutaneous - etiology
Leishmaniasis, Visceral - complications
Leishmaniasis, Visceral - etiology
Leishmaniasis, Visceral - immunology
Leshmaniasis
Malaria, Vivax - complications
Malaria, Vivax - immunology
Male
Measles - complications
Measles - immunology
Medical sciences
Parasitic diseases
PKDL
Protozoal diseases
Recurrence
recurrent kala‐azar
re‐visceralization
Tropical medicine
Tuberculosis, Lymph Node - complications
Tuberculosis, Lymph Node - immunology
Tuberculosis, Pulmonary - complications
Tuberculosis, Pulmonary - immunology
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Summary:Recurrence of kala‐azar after post kala‐azar dermal leishmaniasis (PKDL) has remained uncommon. We report here two patients with recurrence of kala‐azar (KA) after development of PKDL. In one case the second attack of KA was preceded by repeated attacks of malaria and tuberculosis, and in the other the recurrence of KA followed an attack of measles. While measles has earlier been suggested as co‐factor in inducing transformation from sub‐clinical to clinical kala‐azar, malaria was demonstrated to enhance the virulence and invasiveness of Leishmania in an experimental model as well as under natural condition. We propose that in our cases, measles and repeated attacks of malaria or tuberculosis led to immunosuppression and recurrence of visceral leishmaniasis (VL).
ISSN:1360-2276
1365-3156
DOI:10.1046/j.1365-3156.1998.00176.x