PT  - JOURNAL ARTICLE
AU  - M L Álvarez-Nebreda
AU  - E Álvarez-Fernández
AU  - S Rada
AU  - F Brañas
AU  - E Marañón
AU  - M T Vidán
AU  - J A Serra-Rexach
TI  - Unusual duodenal presentation of leishmaniasis
AID  - 10.1136/jcp.2005.027029
DP  - 2005 Dec 01
TA  - Journal of Clinical Pathology
PG  - 1321--1322
VI  - 58
IP  - 12
4099  - http://jcp.bmj.com/content/58/12/1321.short
4100  - http://jcp.bmj.com/content/58/12/1321.full
SO  - J Clin Pathol2005 Dec 01; 58
AB  - 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.