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Pediatr Infect Dis J ; 32(5): e182-5, 2013 May.
Artigo em Inglês | MEDLINE | ID: mdl-23249921

RESUMO

BACKGROUND: The aim of this study was to compare clinical manifestations, laboratory data, morbidity and mortality between adults and children with visceral leishmaniasis, with a focus on kidney function. METHODS: This was a retrospective cohort study with 432 patients with visceral leishmaniasis diagnosed at 1 center in the northeast of Brazil. Patients were divided into 2 groups according to age (>21 years and ≤ 21 years old). RESULTS: The time between onset of symptoms and beginning of treatment was longer in adults (89.5 versus 48.5 days, P < 0.001); signs and symptoms were similar in both groups. Failure of treatment with glucantime was more common in adults (17.6% versus 8.8%, P = 0.008). Acute kidney injury was observed in 160 patients (37.0%), and it was more severe in adults. Risk factors for acute kidney injury in adults were hypokalemia, leukopenia, chills and amphotericin B use. In children, secondary infections were found to increase the risk for acute kidney injury. Overall mortality was 8.8%, and it was significantly higher in adults (12.6% versus 4.1%, P = 0.002). CONCLUSIONS: The adult population had more severe laboratory abnormalities and a worse prognosis, possibly due to delay in diagnosis. Acute kidney injury is prevalent in both groups, and it is usually more severe in adults.


Assuntos
Leishmaniose Visceral/epidemiologia , Injúria Renal Aguda/parasitologia , Adolescente , Adulto , Idoso , Antiprotozoários/uso terapêutico , Brasil/epidemiologia , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Leishmaniose Visceral/tratamento farmacológico , Leishmaniose Visceral/mortalidade , Leishmaniose Visceral/fisiopatologia , Masculino , Meglumina/uso terapêutico , Antimoniato de Meglumina , Pessoa de Meia-Idade , Compostos Organometálicos/uso terapêutico , Estudos Retrospectivos , Fatores de Risco , Estatísticas não Paramétricas , Resultado do Tratamento
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