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J Clin Pathol 2005;58:1321-1322 doi:10.1136/jcp.2005.027029
  • Case report

Unusual duodenal presentation of leishmaniasis

  1. M L Álvarez-Nebreda1,
  2. E Álvarez-Fernández2,
  3. S Rada1,
  4. F Brañas1,
  5. E Marañón1,
  6. M T Vidán1,
  7. J A Serra-Rexach1
  1. 1Geriatrics Department, Hospital General Universitario Gregorio Marañón, 28007 Madrid, Spain
  2. 2Department of Pathology, Hospital General Universitario Gregorio Marañón
  1. Correspondence to:
    Dr M L Álvarez-Nebreda
    Geriatrics Department, Hospital General Universitario Gregorio Marañón, calle Doctor Esquerdo 46, 28007 Madrid, Spain; alvareznebredayahoo.es
  • Accepted 5 April 2005

Abstract

This case report describes an atypical case of duodenal leishmaniasis in an elderly patient not infected with human immunodeficiency virus. Investigation of this 84 year old woman with a constitutional syndrome and dysphagia revealed anaemia of chronic disorder, a high erythrocyte sedimentation rate, and polyclonal hypergammaglobulinaemia. Abdominal ultrasonography revealed thickening of the stomach wall, which was seen to be inflamed during gastroscopy. Duodenal histology revealed numerous leishmania amastigotes within macrophages. This was confirmed by bone marrow biopsy and leishmania serology. This case report stresses the importance of atypical symptoms and the unusual location of visceral leishmaniasis, not only in immunodepressed patients, but also in elderly immunocompetent patients.

Footnotes

  • The patient gave her informed consent for this case report to be published.

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