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      • Record: found
      • Abstract: found
      • Article: found
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      Visceral leishmaniasis in a patient with diabetes mellitus type 2 and discrete bicytopenia

      case-report

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          Key Clinical Message

          An Austrian patient with diabetes mellitus type 2 developed visceral leishmaniasis after trips to Spain and Crete, presenting with slight bicytopenia, later developing severe pancytopenia. Travel history taking is important due to an extended incubation period. Coexistence of diabetes mellitus can impair T lymphocyte function and cause higher relapse rates.

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          Most cited references14

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          Infections in patients with diabetes mellitus.

          Nirmal Joshi, Gregory Caputo, Michael Weitekamp … (1999)
          Article 0 comments Cited 228 times – based on 0 reviews     Review now
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            Consequences of alcohol consumption on host defence.

            B Szabo (2015)
            This communication reviews recent literature and summarizes current views on the immunomodulatory effects of acute and chronic alcohol consumption. Chronic and even acute, moderate alcohol use can increase host susceptibility to infections caused by bacterial and viral pathogens. Impaired host defence after alcohol exposure appears to be linked to a combination of decreased inflammatory response, altered cytokine production, and abnormal reactive oxygen intermediate generation. Furthermore, cellular immunity, particularly antigen-specific immune response, is impaired by both acute and chronic alcohol use. Although T lymphocyte functions can be directly affected by ethanol, decreased antigen presenting cell function appears to be a key element in the ethanol-induced decrease in cell-mediated immunity. In addition, a preferential induction of Th2 vs Th1 immune response has been suggested, based on the increased immunoglobulin levels seen in chronic alcoholics. The effects of chronic and acute alcohol consumption in humans, animal models and in vitro systems on host defence and immunity are discussed in the context of the functional abnormalities of T and B lymphocytes, natural killer cells and monocytes/macrophages resulting in the altered immune response seen after alcohol use.
            Article 0 comments Cited 50 times – based on 0 reviews     Review now
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              Polyclonal B cell activation, circulating immune complexes and autoimmunity in human american visceral leishmaniasis.

              K B Marzochi, J Sá, Michele P Lambert … (1984)
              In a prospective study, serum and plasma samples from 17 patients with kala-azar were collected in Rio de Janeiro. High levels of immune complexes (IC) were detected in serum by means of 125I-Clq and conglutinin binding assays. The Clq binding material had a sedimentation coefficient of 19-25S, as determined by ultracentrifugation on sucrose gradient. Plasma levels of C3 and C3 breakdown products were measured and the C3d levels were increased in six out of 11 patients. The occurrence of polyclonal B cell activation was suggested by (a) a marked increase of serum IgG and IgM levels and (b) of the presence of antibodies against various proteins and haptens (SRBC, DNP-BSA, FITC-BSA,KLH). There was a close association between the presence of IC and anti-immunoglobulin antibodies. Anti-smooth muscle antibodies were also observed. These data are consistent with a major role of polyclonal B cell activation in the induction of IC during visceral leishmaniasis.
              Article 0 comments Cited 38 times – based on 0 reviews     Review now
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                Author and article information

                Contributors
                Julia K. Mader:
                ORCID: http://orcid.org/0000-0001-7854-4233
                julia.mader@medunigraz.at
                Journal
                Journal ID (nlm-ta): Clin Case Rep
                Journal ID (iso-abbrev): Clin Case Rep
                Journal ID (doi): 10.1002/(ISSN)2050-0904
                Journal ID (publisher-id): CCR3
                Title: Clinical Case Reports
                Publisher: John Wiley and Sons Inc. (Hoboken )
                ISSN (Electronic): 2050-0904
                Publication date (Electronic): 28 November 2017
                Publication date Collection: January 2018
                Volume: 6
                Issue: 1 ( doiID: 10.1002/ccr3.2018.6.issue-1 )
                Pages: 78-81
                Affiliations
                [ 1 ] Division of Endocrinology and Diabetology Department of Internal Medicine Medical University of Graz Auenbruggerplatz 15 8036 Graz Austria
                [ 2 ] Division of Nephrology Department of Internal Medicine Medical University of Graz Auenbruggerplatz 15 8036 Graz Austria
                [ 3 ] Department of Pathology Medical University of Graz Neue Stiftingtalstraße 6 8010 Graz Austria
                [ 4 ] Division of Nuclear Medicine Department of Radiology Medical University of Graz Auenbruggerplatz 9 8036 Graz Austria
                [ 5 ] Division of Haematology Department of Internal Medicine Medical University of Graz Auenbruggerplatz 15 8036 Graz Austria
                [ 6 ] Department of Internal Medicine Section of Infectious Diseases and Tropical Medicine Medical University of Graz Auenbruggerplatz 15 8036 Graz Austria
                Author notes
                [*] [* ] Correspondence

                Julia K. Mader, Division of Endocrinology and Diabetology, Department of Internal Medicine, Medical University of Graz, Auenbruggerplatz 15, 8036 Graz, Austria. Tel: +43 316 385 82383; Fax: +43 316 385 13428; E‐mail: julia.mader@ 123456medunigraz.at

                Author information
                http://orcid.org/0000-0002-2378-689X
                http://orcid.org/0000-0001-7854-4233
                Article
                Publisher ID: CCR31259
                DOI: 10.1002/ccr3.1259
                PMC ID: 5771930
                PubMed ID: 29375842
                SO-VID: b4139272-e27b-4f50-a91c-a0798121e755
                Copyright © © 2017 The Authors. Clinical Case Reports published by John Wiley & Sons Ltd.
                License:

                This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

                History
                Date received : 22 August 2017
                Date revision received : 10 September 2017
                Date accepted : 30 September 2017
                Page count
                Figures: 2, Tables: 0, Pages: 4, Words: 2374
                Categories
                Subject: Case Report
                Subject: Case Reports
                Custom metadata
                source-schema-version-number 2.0
                component-id ccr31259
                cover-date January 2018
                details-of-publishers-convertor Converter:WILEY_ML3GV2_TO_NLMPMC version:version=5.3.1 mode:remove_FC converted:17.01.2018

                Keywords: leishmania,pancytopenia,splenomegaly,visceral leishmaniasis
                Data availability:
                Keywords: leishmania, pancytopenia, splenomegaly, visceral leishmaniasis

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