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Table 3 Clinical characteristics according to immunological status

From: Clinical aspects of visceral leishmaniasis caused by L. infantum in adults. Ten years of experience of the largest outbreak in Europe: what have we learned?

 IC-VL (n = 84)HIV-VL (n = 11)IS-VL (n = 16)Total VL (n = 111)P-value
Male (%)738256710.297
Age (mean ± SD, years)44.0 ± 16.538.2 ± 8.054.8 ± 16.045.0 ± 16.9ANOVA: F(2, 110) = 6.22, P = 0.017*
Immigrants (%)58731353χ2 = 13.22, df = 2, P = 0.001*
Sub-Saharan origin (%)54361346χ2 = 9.58, df = 2, P = 0.008*
Diabetes (%)16913140.828
Distance to park (mean ± SD, m)922 ± 566928 ± 701917 ± 544921 ± 5690.999
Delay of diagnosisa (median (IQR), days)18.5 (14–30)21 (16–60)24 (10–60)20 (13–30)0.640
Fever (%)98739495χ2 = 11.81, df = 2, P = 0.003*
Asthenia (%)494669510.315
Weight loss (%)403631390.786
Anorexia (%)333625320.784
Cough (%)313631320.836
Cephalea (%)35919300.113
Vomiting (%)2190160.056
Abdominal pain (%)151812150.762
Odynophagia (%)109690.906
Diarrhoea (%)6181380.314
Dyspnoea (%)79060.512
Weight (mean ± SD, kg)78.5 ± 19.168.3 ± 18.076.4 ± 20.177.1 ± 19.20.254
Clinical splenomegaly (%)294631310.537
Radiological splenomegaly, n/T (%)75/79 (95)10/11 (91)13/15 (87)930.472
Spleen size (mean ± SD, cm)15.7 ± 2.015.9 ± 2.115.2 ± 2.3215.7 ± 2.00.627
Anaemia (haemoglobin < 12 mg/dl) (%)878294870.599
Haemoglobin (mean ± SD, mg/dl)10.2 ± 1.710.9 ± 1.39.4 ± 1.510.2 ± 1.7ANOVA: F(2, 106) = 3.24, P = 0.043*
Leukopenia (< 4000/mm3) (%)908294900.587
Leucocytes (mean ± SD, mm3)2715 ± 9022513 ± 12082470 ± 10832658 ± 9580.565
Thrombocytopenia (< 150,000/mm3) (%)9391100940.512
Platelets (mean ± SD, mm3)93,379 ± 41,771103,364 ± 38,26377,875 ± 29,13292,111 ± 40,0770.228
CRP (mean ± SD, mg/dl)12.2 ± 7.38.3 ± 6.89.2± 6.911.3 ± 7.30.112
CRP > 10 mg/dl563638510.225
Ferritin (median (IQR), ng/ml)2264 (914–6368.5)712 (469–1098.5)1854 (1146–5369)1969 (838–5784)Kruskal-Wallis H-test: χ2 = 6.31, df = 2, P = 0.043*
Ferritin > 1000 ng/ml, n/T (%)56/73 (77)1/6 (17)11/14 (79)68/93 (73)χ2 = 11.81, df = 2, P = 0.005*
ESR, n/T (mean ± SD, mm/h)25/44 (73 ± 32)3/6 (73 ± 26)2/11 (60 ± 35)30/61 (71 ±32)0.494
ESR > 70 mm/h, n/T (%)25/44 (57)3/6 (50)2/11 (18)30/61 (49)0.072
Triglycerides (mean ± SD, mg/dl)220 ± 81170 ± 66203 ± 64211 ± 780.124
HLHb, n (%)31 (37)2 (18)9 (56)42 (38)0.129
Auto-antibody positive, n/T (%)13/44 (30)2/4 (50)3/14 (21)18/62 (29)0.535
Serology infectious diseasesc positives, n/T (%)25/55 (46)1/6 (17)5/10 (50)31/71 (44)0.366
  1. aTime in days from when patient noticed symptoms to diagnosis
  2. bHLH criteria are shown in Table 4
  3. cIgG positive for other infectious diseases: Borrelia burgdorferi 11, Coxiella burnetti 10, Parvovirus 6, Mycoplasma 4, Chlamydophila 4, Rickettsia 4, Syphilis RPR 2
  4. Abbreviations: n, sample size for each group; IC-VL, visceral leishmaniasis in immunocompetent patients; HIV-VL, visceral leishmaniasis in patients with HIV; IS-VL, visceral leishmaniasis in immunosuppressed patients (receiving steroids, methotrexate, anti-TNF), SD, standard deviation; IR, interquartile range; n/T, number of positives/total number tested; CRP, C-reactive protein; ESR, erythrocyte sedimentation rate; HLH: haemophagocytic lymphohistiocytosis
  5. *P < 0.05