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Visceral Leishmaniasis Associated with B-Cell Chronic Lymphocytic Leukemia: Report of a Case and Review of the Literature

Infections often complicate the course of hematological diseases and may represent a diagnostic challenge. In particular, visceral leishmaniasis diagnosis may be missed in lymphoma patients, as lymphoma-related immunosuppression can lead to a misleadingly negative Leishmania serology and to atypical...

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Autores principales: Zanelli, Magda, Tafuni, Alessandro, Sanguedolce, Francesca, Zizzo, Maurizio, Palicelli, Andrea, Simonetti, Edoardo, Scarpelli, Nando, Quintini, Martina, Rosignoli, Daniele, Grasselli, Sara, Cavazza, Alberto, Martino, Giovanni, Ascani, Stefano
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8880775/
https://www.ncbi.nlm.nih.gov/pubmed/35207473
http://dx.doi.org/10.3390/life12020185
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author Zanelli, Magda
Tafuni, Alessandro
Sanguedolce, Francesca
Zizzo, Maurizio
Palicelli, Andrea
Simonetti, Edoardo
Scarpelli, Nando
Quintini, Martina
Rosignoli, Daniele
Grasselli, Sara
Cavazza, Alberto
Martino, Giovanni
Ascani, Stefano
author_facet Zanelli, Magda
Tafuni, Alessandro
Sanguedolce, Francesca
Zizzo, Maurizio
Palicelli, Andrea
Simonetti, Edoardo
Scarpelli, Nando
Quintini, Martina
Rosignoli, Daniele
Grasselli, Sara
Cavazza, Alberto
Martino, Giovanni
Ascani, Stefano
author_sort Zanelli, Magda
collection PubMed
description Infections often complicate the course of hematological diseases and may represent a diagnostic challenge. In particular, visceral leishmaniasis diagnosis may be missed in lymphoma patients, as lymphoma-related immunosuppression can lead to a misleadingly negative Leishmania serology and to atypical clinical manifestations, including the lack of fever, considered a common symptom in leishmaniasis. Herein, we report a case of visceral leishmaniasis in a patient with a long history of B-cell chronic lymphocytic leukemia presenting with increasing fatigue and diarrhea, in the absence of fever. Leishmania serology was negative. Bone marrow biopsy performed with the clinical suspicion of transformation to high-grade lymphoma disclosed intracytoplasmic inclusion bodies resembling Leishmania amastigotes within the cytoplasm of macrophages, and CD1a immunohistochemical expression helped to confirm the diagnosis of leishmaniasis. Liposomal amphotericin B was administered with complete symptom resolution. The correct identification of Leishmania is critical as visceral leishmaniasis represents a severe disease with an often fatal outcome, particularly in frail patients, unless promptly recognized and adequately treated. A review of the literature of visceral leishmaniasis cases occurring in B-cell chronic lymphocytic leukemia patients is performed.
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spelling pubmed-88807752022-02-26 Visceral Leishmaniasis Associated with B-Cell Chronic Lymphocytic Leukemia: Report of a Case and Review of the Literature Zanelli, Magda Tafuni, Alessandro Sanguedolce, Francesca Zizzo, Maurizio Palicelli, Andrea Simonetti, Edoardo Scarpelli, Nando Quintini, Martina Rosignoli, Daniele Grasselli, Sara Cavazza, Alberto Martino, Giovanni Ascani, Stefano Life (Basel) Case Report Infections often complicate the course of hematological diseases and may represent a diagnostic challenge. In particular, visceral leishmaniasis diagnosis may be missed in lymphoma patients, as lymphoma-related immunosuppression can lead to a misleadingly negative Leishmania serology and to atypical clinical manifestations, including the lack of fever, considered a common symptom in leishmaniasis. Herein, we report a case of visceral leishmaniasis in a patient with a long history of B-cell chronic lymphocytic leukemia presenting with increasing fatigue and diarrhea, in the absence of fever. Leishmania serology was negative. Bone marrow biopsy performed with the clinical suspicion of transformation to high-grade lymphoma disclosed intracytoplasmic inclusion bodies resembling Leishmania amastigotes within the cytoplasm of macrophages, and CD1a immunohistochemical expression helped to confirm the diagnosis of leishmaniasis. Liposomal amphotericin B was administered with complete symptom resolution. The correct identification of Leishmania is critical as visceral leishmaniasis represents a severe disease with an often fatal outcome, particularly in frail patients, unless promptly recognized and adequately treated. A review of the literature of visceral leishmaniasis cases occurring in B-cell chronic lymphocytic leukemia patients is performed. MDPI 2022-01-27 /pmc/articles/PMC8880775/ /pubmed/35207473 http://dx.doi.org/10.3390/life12020185 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Case Report
Zanelli, Magda
Tafuni, Alessandro
Sanguedolce, Francesca
Zizzo, Maurizio
Palicelli, Andrea
Simonetti, Edoardo
Scarpelli, Nando
Quintini, Martina
Rosignoli, Daniele
Grasselli, Sara
Cavazza, Alberto
Martino, Giovanni
Ascani, Stefano
Visceral Leishmaniasis Associated with B-Cell Chronic Lymphocytic Leukemia: Report of a Case and Review of the Literature
title Visceral Leishmaniasis Associated with B-Cell Chronic Lymphocytic Leukemia: Report of a Case and Review of the Literature
title_full Visceral Leishmaniasis Associated with B-Cell Chronic Lymphocytic Leukemia: Report of a Case and Review of the Literature
title_fullStr Visceral Leishmaniasis Associated with B-Cell Chronic Lymphocytic Leukemia: Report of a Case and Review of the Literature
title_full_unstemmed Visceral Leishmaniasis Associated with B-Cell Chronic Lymphocytic Leukemia: Report of a Case and Review of the Literature
title_short Visceral Leishmaniasis Associated with B-Cell Chronic Lymphocytic Leukemia: Report of a Case and Review of the Literature
title_sort visceral leishmaniasis associated with b-cell chronic lymphocytic leukemia: report of a case and review of the literature
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8880775/
https://www.ncbi.nlm.nih.gov/pubmed/35207473
http://dx.doi.org/10.3390/life12020185
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