Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020:62:e28.
doi: 10.1590/s1678-9946202062028. Epub 2020 May 11.

A comprehensive systematic review of leishmaniasis in patients undergoing drug-induced immunosuppression for the treatment of dermatological, rheumatological and gastroenterological diseases

Patrícia Shu Kurizky  1   2   3   4 , Fernanda Ferraço Marianelli  2 , Mariana Vicente Cesetti  1 , Giovanni Damiani  5   6   7 , Raimunda Nonata Ribeiro Sampaio  1   3   4   8 , Lais Mitsue Tanaka Gonçalves  2 , Carlos Augusto Felipe de Sousa  1 , Sofia Sales Martins  8 , Sebastian Vernal  9 , Licia Maria Henrique da Mota  1   2 , Ciro Martins Gomes  1   2   3   4   10
Affiliations

A comprehensive systematic review of leishmaniasis in patients undergoing drug-induced immunosuppression for the treatment of dermatological, rheumatological and gastroenterological diseases

Patrícia Shu Kurizky et al. Rev Inst Med Trop Sao Paulo. 2020.

Abstract

Immunosuppression is an important risk factor for leishmaniasis. We assessed the clinical profile, geographic distribution and prevalence of leishmaniasis in patients undergoing immunosuppressive therapy for dermatological, rheumatological or gastroenterological autoimmune diseases. We identified relevant studies in PubMed, EMBASE, Scopus, Web of Science and LILACS on July 3rd, 2018. We included articles that reported at least one case of leishmaniasis in patients undergoing immunosuppressive treatment for dermatological, rheumatological or gastroenterological diseases. Our protocol was registered in PROSPERO (CRD42018103050). We assessed the quality of the included studies with the Joanna Briggs Institute Critical Appraisal Tool. After the removal of duplicates, 5,431 articles were collected and screened. We included 138 articles; the prevalence of leishmaniasis in six methodologically similar studies varied from three to 1,282 cases per 100,000 patients using anti-TNFα drugs, but the results were significantly heterogeneous . Leishmaniasis in patients treated with immunosuppressive drugs is a health problem mostly reported in European countries bordering the Mediterranean Sea; sporadic activities, such as travelling, seem not to be associated with a significant risk of leishmaniasis, although effective control measures must always be observed.

PubMed Disclaimer

Conflict of interest statement

CONFLICT OF INTERESTS

In the previous 12 months, Dr. Mota served as a consultant for Janssen Biologics, Abbvie, Novartis Corp., Pfizer Inc. and Eli Lilly, received honoraria and received payment for continuing medical education work related to psoriasis that was supported by Eli Lilly, Janssen, Novartis and Abbvie.

Figures

Figure 1
Figure 1. Current clinical pathway for the occurrence of leishmaniasis in immunosuppressed patients.
Figure 2
Figure 2. The flow diagram of the search and selection process of articles.
Figure 3
Figure 3. Geographical distribution of the reported leishmaniasis cases in patients with medication-induced immunosuppression.
Figure 4
Figure 4. A forest plot showing the effect sizes and confidence intervals of the six methodologically similar studies that assessed the occurrence of leishmaniasis in patients using TNF-α inhibitors. The visual and statistical evaluations showed substantial heterogeneity, making the pooled results unreliable. CI = Confidence intervals.
See this image and copyright information in PMC

References

    1. Rakotonarivo L, Lons-Danic D, Janier M. Plurifocal cutaneous leishmaniasis during treatment with ustekinumab. JAAD Case Rep. 2018;4:298–300. - PMC - PubMed
    1. Name RQ, Borges KT, Nogueira LS, Sampaio JH, Tauil PL, Sampaio RN. Estudo clínico, epidemiológico e terapêutico de 402 pacientes com leishmaniose tegumentar americana atendidos no Hospital Universitário de Brasília, DF, Brasil. An Bras Dermatol. 2005;80:249–254.
    1. Carranza-Tamayo CO, Assis TS, Neri AT, Cupolillo E, Rabello A, Romero GA. Prevalence of Leishmania infection in adult HIV/AIDS patients treated in a tertiary-level care center in Brasilia, Federal District, Brazil. Trans R Soc Trop Med Hyg. 2009;103:743–748. - PubMed
    1. van Griensven J, Carrillo E, López-Vélez R, Lynen L, Moreno J. Leishmaniasis in immunosupressed individuals. Clin Microbiol Infect. 2014;20:286–299. - PubMed
    1. Arens K, Filippis C, Kleinfelder H, Goetzee A, Reichmann G, Crauwels P, et al. Anti-tumor necrosis factor α therapeutics differentially affect Leishmania infection of human macrophages. 1772Front Immunol. 2018;9 - PMC - PubMed

Publication types

MeSH terms

Substances