LUCIA MARIA ALMEIDA BRAZ
Projetos de Pesquisa
Unidades Organizacionais
Departamento de Medicina Preventiva, Faculdade de Medicina
LIM/38 - Laboratório de Epidemiologia e Imunobiologia, Hospital das Clínicas, Faculdade de Medicina
LIM/38 - Laboratório de Epidemiologia e Imunobiologia, Hospital das Clínicas, Faculdade de Medicina
3 resultados
Resultados de Busca
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- Post-kala-azar dermal leishmaniasis and leprosy: case report and literature review(2015) TRINDADE, Maria Angela Bianconcini; SILVA, Lana Luiza da Cruz; BRAZ, Lucia Maria Almeida; AMATO, Valdir Sabbaga; NAAFS, Bernard; SOTTO, Mirian NacagamiBackground: Post-kala-azar dermal leishmaniasis (PKDL) is a dermal complication of visceral leishmaniasis (VL), which may occur after or during treatment. It has been frequently reported from India and the Sudan, but its occurrence in South America has been rarely reported. It may mimic leprosy and its differentiation may be difficult, since both diseases may show hypo-pigmented macular lesions as clinical presentation and neural involvement in histopathological investigations. The co-infection of leprosy and VL has been reported in countries where both diseases are endemic. The authors report a co-infection case of leprosy and VL, which evolved into PKDL and discuss the clinical and the pathological aspects in the patient and review the literature on this disease. Case presentation: We report an unusual case of a 53-year-old female patient from Alagoas, Brazil. She presented with leprosy and a necrotizing erythema nodosum, a type II leprosy reaction, about 3 month after finishing the treatment (MDT-MB) for leprosy. She was hospitalized and VL was diagnosed at that time and she was successfully treated with liposomal amphotericin B. After 6 months, she developed a few hypo-pigmented papules on her forehead. A granulomatous inflammatory infiltrate throughout the dermis was observed at histopathological examination of the skin biopsy. It consisted of epithelioid histiocytes, lymphocytes and plasma cells with the presence of amastigotes of Leishmania in macrophages (Leishman's bodies). The diagnosis of post-kala-azar dermal leishmaniasis was established because at this time there was no hepatosplenomegaly and the bone marrow did not show Leishmania parasites thus excluding VL. About 2 years after the treatment of PKDL with liposomal amphotericin B the patient is still without PKDL lesions. Conclusion: Post-kala-azar dermal leishmaniasis is a rare dermal complication of VL that mimics leprosy and should be considered particularly in countries where both diseases are endemic. A co-infection must be seriously considered, especially in patients who are non-responsive to treatment or develop persistent leprosy reactions as those encountered in the patient reported here.
- Visceral leishmaniasis reactivation diagnosed by molecular technique in blood sample(2012) BRAZ, L.; NICODEMO, A.; SOUZA, R.; SANTOS, N.; GODOY, N.; OKAY, T.; AMATO, V.Background: It is possible to perform the serological diagnosis of visceral leishmaniasis through k39 immunochromatographic test. However, usually in the co-infection visceral leishmaniasis with HIV k39 strip results are not conclusive. Then, investigation by microscopic examination of smear, culture medium NNN/BHI and PCR can be performed in bone marrow aspirates (gold standard) or blood sample. In this case report PCR in blood sample proved to be useful for monitoring reactivation of visceral leishmaniasis in a patient with HIV. Methods: In four different periods of a patient hospitalization with visceral leishmaniasis, samples of bone marrow aspirates and peripheral blood were examined. They were evaluated by microscopic examination of smear stained by Panóptico, culture medium NNN/BHI and PCR targeting the kDNA. Results: In four different periods of patient hospitalization the samples from bone marrow aspirates and blood sample presented amastigotes after smear microscopic examination. By PCR (kDNA) the samples from bone marrow aspirates and blood sample showed a 120-bp band on the electrophoresis gel. And promastigotes were found in the culture medium NNN/BHI from aspirated bone marrow only in the last hospitalization. Conclusion: Aspiration of bone marrow, the gold-standard diagnostic laboratory of visceral leishmaniasis, is known to be invasive and painful. However, it is possible to diagnose the disease through k39 immunochromatographic test. But usually in patients coinfected with HIV the k39 results are not conclusive. And the microscopic examination of smear is subjective and extremely time consuming. Our results of positive PCR (120 bp) in both bone marrow aspirates and in the blood sample demonstrated the importance of PCR in detection of visceral leishmaniasis reactivation. PCR results in blood samples suggest the possibility of replacing the PCR and even the smear examination in bone marrow aspirates to detect reactivation.
- Genetic variability of Leishmania (Leishmania) infantum causing human visceral leishmaniasis in the Southeastern Brazil(2023) LIMA, Vinicius Alves; SILVA, Renata Elen Costa; CAMARGO, Luiz Henrique Moraes Caetano; HIRAMOTO, Roberto Mitsuyoshi; LEAL, Elcio de Souza; BRAZ, Lucia Maria Almeida; LINDOSO, Jose Angelo LaulettaLeishmania infantum is a protozoan that causes visceral leishmaniasis (VL) in the Americas and some regions of Europe. The disease is mainly characterized by hepatosplenomegaly and fever, and can be fatal. Factors related to the host and parasite can contribute to the transmission of Leishmania and the clinical outcome. The intraspecific genetic variability of L. infantum strains may be one of these factors. In this study, we evaluated the genetic variability of L. infantum obtained from bone marrow smear slides from patients in the Sao Paulo State, Brazil. For this, the minicircle of the kDNA hypervariable region was used as target by Sanger sequencing. By analyzing the similarity of the nucleotides and the maximum likelihood tree (Fasttree), we observed a high similarity (98%) among samples. Moreover, we identified four different profiles of L. infantum. In conclusion, L. infantum strains from Sao Paulo State, Brazil, showed low diversity measured by minicircle of the kDNA hypervariable region.