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A clinical isolate of Leishmania donovani with ITS1 sequence polymorphism as a cause of para-kala-azar dermal leishmaniasis in an Ethiopian human immunodeficiency virus-positive patient on highly active antiretroviral therapy.
Br J Dermatol. 2010 Oct; 163(4):870-4.BJ

Abstract

The diagnosis of para-kala-azar dermal leishmaniasis (PKDL/VL), either as an immune reconstitution inflammatory syndrome (IRIS)-associated syndrome or as a complication of visceral leishmaniasis (VL) during human immunodeficiency virus (HIV) co-infection in patients with or without highly active antiretroviral therapy, represents a challenge for prompt treatment. The aim of this study was to identify the causative Leishmania species and to clarify whether the post-kala-azar dermal leishmaniasis (PKDL)-like lesions appeared as a result of IRIS or not. A 31-year-old Ethiopian male patient, with stage IV HIV/acquired immune deficiency syndrome (AIDS), was clinically diagnosed with PKDL/VL. He had developed a generalized maculopapular rash on his face after initiation of highly active antiretroviral therapy. The Leishmania isolate obtained from the skin lesions was analysed by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) and sequencing of the ribosomal DNA internal transcribed spacer 1 (ITS1) and partial coding sequences of the heat shock protein 70 gene (hsp70). Restriction analysis of the ITS1 PCR product gave a unique RFLP pattern not seen before for any Leishmania isolate. Sequencing of both the ITS1 and hsp70 PCR products identified the causative species as Leishmania donovani, and further revealed the existence of five different sequence variants of the ITS1 among the 10 clones sequenced. The results indicate that PKDL/VL resulted from an infection by L. donovani. The sequence variants of ITS1 might be due to the presence of multiple strains/clones or the existence of intragenomic variations in the multicopy ITS1, or a combination of both.

Authors+Show Affiliations

Institut für Mikrobiologie und Hygiene, Charité Universitätsmedizin Berlin, Dorotheenstraβe 96, D-10117 Berlin, Germany. tesfayegela2002@yahoo.comNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Case Reports
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

20331449

Citation

Gelanew, T, et al. "A Clinical Isolate of Leishmania Donovani With ITS1 Sequence Polymorphism as a Cause of Para-kala-azar Dermal Leishmaniasis in an Ethiopian Human Immunodeficiency Virus-positive Patient On Highly Active Antiretroviral Therapy." The British Journal of Dermatology, vol. 163, no. 4, 2010, pp. 870-4.
Gelanew T, Amogne W, Abebe T, et al. A clinical isolate of Leishmania donovani with ITS1 sequence polymorphism as a cause of para-kala-azar dermal leishmaniasis in an Ethiopian human immunodeficiency virus-positive patient on highly active antiretroviral therapy. Br J Dermatol. 2010;163(4):870-4.
Gelanew, T., Amogne, W., Abebe, T., Kuhls, K., Hailu, A., & Schönian, G. (2010). A clinical isolate of Leishmania donovani with ITS1 sequence polymorphism as a cause of para-kala-azar dermal leishmaniasis in an Ethiopian human immunodeficiency virus-positive patient on highly active antiretroviral therapy. The British Journal of Dermatology, 163(4), 870-4. https://doi.org/10.1111/j.1365-2133.2010.09768.x
Gelanew T, et al. A Clinical Isolate of Leishmania Donovani With ITS1 Sequence Polymorphism as a Cause of Para-kala-azar Dermal Leishmaniasis in an Ethiopian Human Immunodeficiency Virus-positive Patient On Highly Active Antiretroviral Therapy. Br J Dermatol. 2010;163(4):870-4. PubMed PMID: 20331449.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A clinical isolate of Leishmania donovani with ITS1 sequence polymorphism as a cause of para-kala-azar dermal leishmaniasis in an Ethiopian human immunodeficiency virus-positive patient on highly active antiretroviral therapy. AU - Gelanew,T, AU - Amogne,W, AU - Abebe,T, AU - Kuhls,K, AU - Hailu,A, AU - Schönian,G, PY - 2010/3/25/entrez PY - 2010/3/25/pubmed PY - 2011/3/9/medline SP - 870 EP - 4 JF - The British journal of dermatology JO - Br J Dermatol VL - 163 IS - 4 N2 - The diagnosis of para-kala-azar dermal leishmaniasis (PKDL/VL), either as an immune reconstitution inflammatory syndrome (IRIS)-associated syndrome or as a complication of visceral leishmaniasis (VL) during human immunodeficiency virus (HIV) co-infection in patients with or without highly active antiretroviral therapy, represents a challenge for prompt treatment. The aim of this study was to identify the causative Leishmania species and to clarify whether the post-kala-azar dermal leishmaniasis (PKDL)-like lesions appeared as a result of IRIS or not. A 31-year-old Ethiopian male patient, with stage IV HIV/acquired immune deficiency syndrome (AIDS), was clinically diagnosed with PKDL/VL. He had developed a generalized maculopapular rash on his face after initiation of highly active antiretroviral therapy. The Leishmania isolate obtained from the skin lesions was analysed by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) and sequencing of the ribosomal DNA internal transcribed spacer 1 (ITS1) and partial coding sequences of the heat shock protein 70 gene (hsp70). Restriction analysis of the ITS1 PCR product gave a unique RFLP pattern not seen before for any Leishmania isolate. Sequencing of both the ITS1 and hsp70 PCR products identified the causative species as Leishmania donovani, and further revealed the existence of five different sequence variants of the ITS1 among the 10 clones sequenced. The results indicate that PKDL/VL resulted from an infection by L. donovani. The sequence variants of ITS1 might be due to the presence of multiple strains/clones or the existence of intragenomic variations in the multicopy ITS1, or a combination of both. SN - 1365-2133 UR - https://www.unboundmedicine.com/medline/citation/20331449/A_clinical_isolate_of_Leishmania_donovani_with_ITS1_sequence_polymorphism_as_a_cause_of_para_kala_azar_dermal_leishmaniasis_in_an_Ethiopian_human_immunodeficiency_virus_positive_patient_on_highly_active_antiretroviral_therapy_ L2 - https://doi.org/10.1111/j.1365-2133.2010.09768.x DB - PRIME DP - Unbound Medicine ER -