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Membranoproliferative Glomerulonephritis due to Visceral Leishmaniasis in an HIV Patient

Ricardo Enríquez, Ana Esther Sirvent, Sergio Padilla, Paula Toro, María Sánchez, Isabel Millán

(Nephrology Section, Hospital General Universitario de Elche, Elche, Spain)

Am J Case Rep 2015; 16:8-11

DOI: 10.12659/AJCR.892641

Background: Visceral leishmaniasis is an important opportunistic disease in HIV-positive patients. The information available on the effects of such co-infection in the kidney is limited. We describe a patient with HIV/leishmania coinfection who developed nephrotic syndrome and membranoproliferative glomerulonephritis. As far as we know, only 2 cases of this nephropathy in HIV/leishmania coinfection have been reported.
Case Report: A 47-year-old man developed nephrotic syndrome. He had been diagnosed with HIV infection and visceral leishmaniasis and was treated with antiretroviral therapy, antimonial compounds, liposomal amphotericin B and miltefosine, but the leishmania followed a relapsing course.
Renal biopsy disclosed membranoproliferative glomerulonephritis and leishmania amastigotes were seen within glomerular capillary lumens. He was given miltefosine and liposomal amphotericin B but the leishmaniasis persisted. Stage 3B chronic renal disease and nephrotic range proteinuria tend to become stable by 15-month follow-up.
Conclusions: Our case illustrated some aspects of leishmaniasis in HIV patients: its relapsing course, the difficulties in therapy, and the renal involvement.

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