Glomerulopathy Associated with Visceral leishmaniasis

Background: A fundamental feature of most parasitic infections is their chronicity. Although renal disease is not one of the common presenting features, many parasitic infections are associated with glomerular lesions. Glomerular lesions are observed with visceral leishmaniasis (kala-azar) caused by...

Full description

Bibliographic Details
Main Authors: Sh Khademvatan, M Nobakht, J Saki, L Akhlaghi, F Normosavinasab, A khankeshi
Format: Article
Language:English
Published: Tehran University of Medical Sciences 2007-03-01
Series:Iranian Journal of Public Health
Subjects:
Online Access:https://ijph.tums.ac.ir/index.php/ijph/article/view/2930
_version_ 1818980726790422528
author Sh Khademvatan
M Nobakht
J Saki
L Akhlaghi
F Normosavinasab
A khankeshi
author_facet Sh Khademvatan
M Nobakht
J Saki
L Akhlaghi
F Normosavinasab
A khankeshi
author_sort Sh Khademvatan
collection DOAJ
description Background: A fundamental feature of most parasitic infections is their chronicity. Although renal disease is not one of the common presenting features, many parasitic infections are associated with glomerular lesions. Glomerular lesions are observed with visceral leishmaniasis (kala-azar) caused by Leishmania donovani. Leishmanial parasites affect children under 2 yaer in more than 88 countries. Thus study of glomerulopathy Associated with Visceral leishmaniasis is very important. Methods: In this retrospective study we review the glomerulopathies observed in visceral leishmaniasis and the pathogenic mechanisms thought to be involved in the individual infections, and discuss the general mechanisms that can be extracted from these observations. Results: Prospective studies have shown that 60% of patients with kala-azar have mild proteinuria with benign changes in the urinary sediment (microscopic hematuria and leukocyturia). The pathological picture is a glomerulonephritis ranging from purely mesangioproliferative to membraneoproliferative. Amyloidosis can be a complication of kala-azar. Using immunofluorescence, IgG, IgM, IgA, and C3 are seen in the mesangium with some extensions along the capillary loop. Conclusion: Kala-azar is usually associated with hyperimmunoglobulinemia with high IgG levels, circulating immune complexes, and high titers of rheumatoid factor and cryoglobulin. Together with the presence of immunoglobulins in the glomeruli, this suggests the pivotal role of polyclonal B-cell activation and “classical” B-cell activation in the pathogenesis of leishmanial nephritis.
first_indexed 2024-12-20T17:20:01Z
format Article
id doaj.art-64d0025eedb741259125b98e63d7c9b6
institution Directory Open Access Journal
issn 2251-6085
2251-6093
language English
last_indexed 2024-12-20T17:20:01Z
publishDate 2007-03-01
publisher Tehran University of Medical Sciences
record_format Article
series Iranian Journal of Public Health
spelling doaj.art-64d0025eedb741259125b98e63d7c9b62022-12-21T19:31:53ZengTehran University of Medical SciencesIranian Journal of Public Health2251-60852251-60932007-03-0136Supple 2Glomerulopathy Associated with Visceral leishmaniasis Sh Khademvatan0 M Nobakht1 J Saki2 L Akhlaghi3 F Normosavinasab4 A khankeshi5 Background: A fundamental feature of most parasitic infections is their chronicity. Although renal disease is not one of the common presenting features, many parasitic infections are associated with glomerular lesions. Glomerular lesions are observed with visceral leishmaniasis (kala-azar) caused by Leishmania donovani. Leishmanial parasites affect children under 2 yaer in more than 88 countries. Thus study of glomerulopathy Associated with Visceral leishmaniasis is very important. Methods: In this retrospective study we review the glomerulopathies observed in visceral leishmaniasis and the pathogenic mechanisms thought to be involved in the individual infections, and discuss the general mechanisms that can be extracted from these observations. Results: Prospective studies have shown that 60% of patients with kala-azar have mild proteinuria with benign changes in the urinary sediment (microscopic hematuria and leukocyturia). The pathological picture is a glomerulonephritis ranging from purely mesangioproliferative to membraneoproliferative. Amyloidosis can be a complication of kala-azar. Using immunofluorescence, IgG, IgM, IgA, and C3 are seen in the mesangium with some extensions along the capillary loop. Conclusion: Kala-azar is usually associated with hyperimmunoglobulinemia with high IgG levels, circulating immune complexes, and high titers of rheumatoid factor and cryoglobulin. Together with the presence of immunoglobulins in the glomeruli, this suggests the pivotal role of polyclonal B-cell activation and “classical” B-cell activation in the pathogenesis of leishmanial nephritis.https://ijph.tums.ac.ir/index.php/ijph/article/view/2930Glomerulopathy
spellingShingle Sh Khademvatan
M Nobakht
J Saki
L Akhlaghi
F Normosavinasab
A khankeshi
Glomerulopathy Associated with Visceral leishmaniasis
Iranian Journal of Public Health
Glomerulopathy
title Glomerulopathy Associated with Visceral leishmaniasis
title_full Glomerulopathy Associated with Visceral leishmaniasis
title_fullStr Glomerulopathy Associated with Visceral leishmaniasis
title_full_unstemmed Glomerulopathy Associated with Visceral leishmaniasis
title_short Glomerulopathy Associated with Visceral leishmaniasis
title_sort glomerulopathy associated with visceral leishmaniasis
topic Glomerulopathy
url https://ijph.tums.ac.ir/index.php/ijph/article/view/2930
work_keys_str_mv AT shkhademvatan glomerulopathyassociatedwithvisceralleishmaniasis
AT mnobakht glomerulopathyassociatedwithvisceralleishmaniasis
AT jsaki glomerulopathyassociatedwithvisceralleishmaniasis
AT lakhlaghi glomerulopathyassociatedwithvisceralleishmaniasis
AT fnormosavinasab glomerulopathyassociatedwithvisceralleishmaniasis
AT akhankeshi glomerulopathyassociatedwithvisceralleishmaniasis