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Saudi Journal of Kidney Diseases and Transplantation
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CASE REPORT Table of Contents   
Year : 2010  |  Volume : 21  |  Issue : 1  |  Page : 105-108
Visceral leishmaniasis in a renal transplant recipient treated with allopurinol

1 Unity of Organ Transplantation, Military Hospital, Tunis, Tunisia
2 Department of Parasitology, Military Hospital, Tunis, Tunisia
3 Department of Urology, Military Hospital, Tunis, Tunisia
4 Coordinator of the Transplantation Program, Military Hospital, Tunis, Tunisia
5 Unity of Hemodialysis, Department of Internal Medicine , Military Hospital, Tunis, Tunisia

Correspondence Address:
Kais Harzallah
Unity of Organ Transplantation, Military Hospital, Tunis
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Source of Support: None, Conflict of Interest: None

PMID: 20061702

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Leishmaniasis is an infection caused by a protozoan parasite belonging to the genus Leishmania and transmitted by the Phlebotomus sandfly. We report a case of visceral leishmaniasis in a 49-year-old male renal transplant recipient, a resident of the western part of Tunisia, which is an endemic zone for the disease. Just before and after the transplantation, the patient resided in Tunis, which is non-endemic for leishmaniasis. Visceral leishmaniasis occurred eight years after renal transplantation, and the clinical picture was characterized by fever and pancytopenia. Leish­maniae were detected by bone marrow aspiration. Pentavalent antimonal was used for 28 days and was substituted by allopurinol (20 mg/kg per day). One year after the infection, the patient remains totally asymptomatic. Our report suggests that visceral leishmaniasis may complicate the clinical course of organ transplantation and can be fatal, particularly when untreated. Relapses may occur after completion of the apparently effective treatment. Allopurinol could be a solution to avoid these relapses.

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