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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 (%)

73

82

56

71

0.297

Age (mean ± SD, years)

44.0 ± 16.5

38.2 ± 8.0

54.8 ± 16.0

45.0 ± 16.9

ANOVA: F(2, 110) = 6.22, P = 0.017*

Immigrants (%)

58

73

13

53

χ2 = 13.22, df = 2, P = 0.001*

Sub-Saharan origin (%)

54

36

13

46

χ2 = 9.58, df = 2, P = 0.008*

Diabetes (%)

16

9

13

14

0.828

Distance to park (mean ± SD, m)

922 ± 566

928 ± 701

917 ± 544

921 ± 569

0.999

Delay of diagnosisa (median (IQR), days)

18.5 (14–30)

21 (16–60)

24 (10–60)

20 (13–30)

0.640

Fever (%)

98

73

94

95

χ2 = 11.81, df = 2, P = 0.003*

Asthenia (%)

49

46

69

51

0.315

Weight loss (%)

40

36

31

39

0.786

Anorexia (%)

33

36

25

32

0.784

Cough (%)

31

36

31

32

0.836

Cephalea (%)

35

9

19

30

0.113

Vomiting (%)

21

9

0

16

0.056

Abdominal pain (%)

15

18

12

15

0.762

Odynophagia (%)

10

9

6

9

0.906

Diarrhoea (%)

6

18

13

8

0.314

Dyspnoea (%)

7

9

0

6

0.512

Weight (mean ± SD, kg)

78.5 ± 19.1

68.3 ± 18.0

76.4 ± 20.1

77.1 ± 19.2

0.254

Clinical splenomegaly (%)

29

46

31

31

0.537

Radiological splenomegaly, n/T (%)

75/79 (95)

10/11 (91)

13/15 (87)

93

0.472

Spleen size (mean ± SD, cm)

15.7 ± 2.0

15.9 ± 2.1

15.2 ± 2.32

15.7 ± 2.0

0.627

Anaemia (haemoglobin < 12 mg/dl) (%)

87

82

94

87

0.599

Haemoglobin (mean ± SD, mg/dl)

10.2 ± 1.7

10.9 ± 1.3

9.4 ± 1.5

10.2 ± 1.7

ANOVA: F(2, 106) = 3.24, P = 0.043*

Leukopenia (< 4000/mm3) (%)

90

82

94

90

0.587

Leucocytes (mean ± SD, mm3)

2715 ± 902

2513 ± 1208

2470 ± 1083

2658 ± 958

0.565

Thrombocytopenia (< 150,000/mm3) (%)

93

91

100

94

0.512

Platelets (mean ± SD, mm3)

93,379 ± 41,771

103,364 ± 38,263

77,875 ± 29,132

92,111 ± 40,077

0.228

CRP (mean ± SD, mg/dl)

12.2 ± 7.3

8.3 ± 6.8

9.2± 6.9

11.3 ± 7.3

0.112

CRP > 10 mg/dl

56

36

38

51

0.225

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 ± 81

170 ± 66

203 ± 64

211 ± 78

0.124

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