Visceral leishmaniasis in a patient treated for polyarteritis nodosa

P. Scatena¹, F. Messina², S. Gori³, L. Ruocco³, C. Vignali⁴, F. Menichetti², M. Castiglioni¹

¹Department of Medicine IV; ²Department of Infective Diseases; ³Test Analysis Laboratory; and ⁴Department of Radiodiagnosis I, Azienda Ospedaliera Pisana, Pisa, Italy

ABSTRACT
We report a case of visceral leishmaniasis in a patient receiving steroids and cyclophosphamide for polyarteritis nodosa. The clinical presentation of leishmaniasis, with fever, pancitopenia and hypergammaglobulinemia may be confused with a reactivation of vasculitis or with other non-infectious conditions such as haematologic diseases. 
In endemic areas, the case of latent leishmaniasis must be considered and serology for Leishmania should be performed before starting immunosoppressive treatment.

Key words
Visceral leishmaniasis, polyarteritis nodosa, vasculitis.

Please address correspondence and reprint requests to: Dr Paola Scatena, U.O. Medicina IV, Azienda Ospedaliera Pisana, Cisanello, via Paradisa 2, 
56100 Pisa, Italy. E-mail: brulenz@tin.it

Clin Exp Rheumatol 2003; 21: (Suppl. 32): S121-S123.
© Copyright Clinical and Experimental Rheumatology 2003.