Home Print this page Email this page Small font sizeDefault font sizeIncrease font size
Users Online: 339
Home | About us | Editorial board | Search | Ahead of print | Current issue | Archives | Submit article | Instructions | Subscribe | Contacts | Login 
     


 
 Table of Contents  
LETTER TO EDITOR
Year : 2014  |  Volume : 4  |  Issue : 2  |  Page : 134-135  

Lipid derangement as diagnostic and prognostic indicator for visceral leishmaniasis patients


1 Department of Microbiology, Vardhaman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
2 Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India
3 Department of Cardiac Biochemistry, All India Institute of Medical Sciences, New Delhi, India

Date of Acceptance17-Dec-2013
Date of Web Publication12-Aug-2014

Correspondence Address:
Sarita Mohapatra
Department of Microbiology, Vardhaman Mahavir Medical College and Safdarjung Hospital, New Delhi
India
Login to access the Email id


DOI: 10.4103/2229-5070.138546

PMID: 25250239

Rights and Permissions

How to cite this article:
Mohapatra S, Samantaray JC, Dash S, Ramakrishan L. Lipid derangement as diagnostic and prognostic indicator for visceral leishmaniasis patients. Trop Parasitol 2014;4:134-5

How to cite this URL:
Mohapatra S, Samantaray JC, Dash S, Ramakrishan L. Lipid derangement as diagnostic and prognostic indicator for visceral leishmaniasis patients. Trop Parasitol [serial online] 2014 [cited 2021 Sep 27];4:134-5. Available from: https://www.tropicalparasitology.org/text.asp?2014/4/2/134/138546

Sir,

Visceral leishmaniasis popularly known as Kala-azar, is caused by an intracellular protozoa Leishmania donovani (LD). Fever, hepatosplenomegaly and weight loss are the common presenting features of the disease. Anemia, leukopenia, thrombocytopenia and hyperglobulinemia with alteration of albumin: globulin (A:G) ratio are some of the most common laboratory finding observed in this condition. In India, more than 50% of Kala-azar cases are reported form Bihar. [1] Bone marrow aspiration is the gold standard for diagnosis of visceral leishmaniasis. However, it is a painful procedure, needs expertise and difficult to interpret in low parasitemic conditions. Currently, immunochromatographic test (ICT) coating rk39 recombinant kinesin antigen has become more popular for the diagnosis of Kala-azar. [2] It shows high sensitivity and specificity for the diagnosis of Kala-azar, however has limited role in the disease prognosis. [2] Plasma lipid profile alterations such as hypocholesteraemia, increased triglyceridemia are previously reported in few cases of visceral leishmaniasis. [3-5] However none of them had correlated the above parameters as a diagnostic and prognostic adjunct with that of the established clinical and hematological parameters. Here, we would like to point out these metabolic alterations in nine visceral leismaniasis patients, which might give a clue for the best markers as the diagnostic and prognostic indicator for visceral leishmaniasis cases.

A total nine clinically diagnosed Kala-azar patients were investigated for their lipid profile before the start of treatment. Total serum cholesterol, high density cholesterol, low density lipoprotein, very low density lipoprotein (VLDL) and triglyceride levels were determined. Detail clinical and hematological parameters of these cases were analyzed [Table 1]. Fever with hepatosplenomegaly remained the chief complaints in all patients. Among the hematological parameters anemia and leukopenia were the most constant hematological parameters present in (89%) of cases followed by thrombocytopenia. Five out of nine patients (56%) were residents of Bihar. LD bodies in bone marrow aspirate were confirmed in two out of five patients. All the samples were positive for rk39 ICT (InBios Ltd.). 7/9 patients showed altered A: G ratio. Increased triglyceride level was found to be the most common lipid derangement among 7/9 (78%) cases followed by increased VLDL in 5/9. During our observation, hypocholesterolemia was found only in 3/9 (33%) of patients which was reported earlier. [4] All the patients were treated with injection Amphotericin B (IV infusion of 0.75-1 mg/Kg for 15-20 days alternate). Four cases could be followed-up after completion of treatment. All the clinical, hematological and plasma lipid profile were reviewed on the day of completion of the treatment [Table 2]. 3/4 patients showed normal hematological parameters after the completion of treatment. Among all the lipid profiles, triglyceride level was observed to become normal in all the 4 patients (100%). The alteration of lipid parameters especially triglyceride was significant even in bone marrow aspirate negative patients. We consider in visceral leishmniasis patients, along with the clinical and hematological parameters, triglyceride level (before and after the treatment) will give a better clue for diagnosis and prognosis of these patients.
Table 1: Variations of lipid profile with clinical and hematological parameters in visceral leishmaniasis patients


Click here to view
Table 2: Lipid profile in visceral leishmaniasis patients


Click here to view


 
   References Top

1.Bora D. Epidemiology of visceral leishmaniasis in India. Natl Med J India 1999;12:62-8.  Back to cited text no. 1
[PUBMED]    
2.Goswami RP, Bairagi B, Kundu PK. K39 strip test - Easy, reliable and cost-effective field diagnosis for visceral leishmaniasis in India. J Assoc Physicians India 2003;51:759-61.  Back to cited text no. 2
    
3.Liberopoulos E, Alexandridis G, Bairaktari E, Elisaf M. Severe hypocholesterolemia with reduced serum lipoprotein (a) in a patient with visceral leishmaniasis. Ann Clin Lab Sci 2002;32:305-8.  Back to cited text no. 3
    
4.Lal CS, Verma N, Rabidas VN, Ranjan A, Pandey K, Verma RB, et al. Total serum cholesterol determination can provide understanding of parasite burden in patients with visceral leishmaniasis infection. Clin Chim Acta 2010;411:2112-3.  Back to cited text no. 4
[PUBMED]    
5.Secmeer G, Cengiz AB, Gurgey A, Kara A, Kultu O, Tavil B, et al. Hypertriglyceredemia and decreased high density lipoprotein could be a clue for visceral leishmaniasis. Infect Dis Clin Pract 2006;14:401-2.  Back to cited text no. 5
    



 
 
    Tables

  [Table 1], [Table 2]


This article has been cited by
1 Hypertriglyceridemia: a possible diagnostic marker of disease severity in visceral leishmaniasis
C. S. Lal,R. B. Verma,N. Verma,N. A. Siddiqui,V. N. Rabidas,K. Pandey,D. Singh,S. Kumar,R. K. Paswan,A. Kumari,P. Sinha,P. Das
Infection. 2016; 44(1): 39
[Pubmed] | [DOI]



 

Top
  
 
  Search
 
    Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
    Access Statistics
    Email Alert *
    Add to My List *
* Registration required (free)  

 
  In this article
    References
    Article Tables

 Article Access Statistics
    Viewed1685    
    Printed39    
    Emailed0    
    PDF Downloaded33    
    Comments [Add]    
    Cited by others 1    

Recommend this journal