ECG manifestations of meglumine antimoniate in treatment of cutaneous leishmaniasis
Keywords:
ECG manifestations, Meglumine Antimonate, cutaneous leishmaniasisAbstract
Objective To determine ECG manifestations of Meglumine Antimoniate in treatment of cutaneous leishmaniasis for cutaneous leishmaniasis.Study Design: Cross Sectional. Setting & Study duration This study was conducted at the Department of Dermatology, Bolan Medical College/ Sandeman Provincial Hospital, Quetta from 20th August 2015 to 20th February 2016 (6 months). Material and Methods A total of 245 patients were included in the study. All patients between the ages of 25 to 60 years diagnosed as leishmaniasis and on treatment for > 2 weeks were enrolled. The patients were treated with intra-muscular injections of MA (Glucantime; Aventis, France) at a dose of 20 mg/day for 21 days. ECG was captured on a standard 12 leads format. The diagnosis of ECG manifestations was made based on recording of ECG done at 1st and fourth week after starting treatment. Data was analyzed using Statistical package of Social Sciences (SPSS) version 19. Mean + SD were calculated for continuous variable of age, height, weight, BMI, daily dose and duration of treatment. Results on categorical variables of gender and patient outcome variable i-e Sinus tachycardia, sinus bradycardia, prolong QT interval, T inversion, ST Depression, Q wave were expressed in frequencies and proportions. Stratification of age, gender, duration of treatment, duration of disease and daily dose was done to see their effect on outcome variable. Results A total of 245 patients were included in the study. Mean age of the patients was 54.34±5.02 years. Majority of the patients 189 (77.1%) were males. Mean duration of treatment and duration of disease was 4.98 ±1.56 weeks and 6.20 ±1.82 weeks respectively. Frequency of sinus tachycardia was found in 37 (15.1%) patients, sinus bradycardia 19 (7.8%), T wave inversion 12 (4.9%), prolong QT inversion 38 (15.5%), ST depression 13 (5.3%) while Q wave was observed in 67 (27.3%) patients.9.23 years. Conclusion Our results showed that treatment with Meglumine antimoniate can induce many ECG changes. We suggest that ECG monitoring should be performed in high-risk patients undergoing Meglumine antimoniate treatment with special attention to ECG changes.References
Alam E, Abbas O, Moukarbel R, Khalifeh I. Cutaneous Leishmaniasis: An overlooked etiology of midfacial destructive lesions. PLoS Negl Trop Dis. 2016;10(2):1-8.
Andrews KT, Fisher G, Skinner-Adams TS. Drug repurposing and human parasitic protozoan diseases. Int J Parasitol Drugs Resist. 2014; 4(2):95–111.
Andrews KT, Haque A, Jones MK. HDAC inhibitors in parasitic diseases. Immunol Cell Biol. 2012; 90(1):66–77.
Dunya G, Habib R, Moukarbel RV, Khalifeh I. Head and neck cutaneous leishmania: clinical characteristics, microscopic features and molecular analysis in a cohort of 168 cases. Eur Arch Otorhinolaryngol. 2016; 273(11): 3819-26.
Aoun J, Habib R, Charaffeddine K, Taraif S, Loya A, Khalifeh I. Caseating granulomas in cutaneous leishmaniasis. PLoS Negl Trop Dis. 2014; 8(10): 3255
Crovetto-Martínez R, Aguirre-Urizar JM, Orte-Aldea C, Araluce-Iturbe I, Whyte-Orozco J, Crovetto-De la Torre MA. Mucocutaneous leishmaniasis must be included in the differential diagnosis of midline destructive disease: two case reports. Oral Surg Oral Med Oral Pathol Oral Radiol. 2015; 119(1):20-26.
Abd El-Salam NM, Ayaz S, Ullah R. PCR and microscopic identification of isolated leishmania tropica from clinical samples of cutaneous leishmaniasis in human population of Kohat region in Khyber Pakhtunkhwa. Biomed Res Int 2014;2014:861831
Abid R, Haleem S, Ghani S, Ahmed N, Farman M, Bukhari M, et al. Electrocardiographic changes during treatment with cutaneous leishmaniasis. Pak Heart J. 2013;46(1):51–55.
WHO. The world health report 2004. Changing history. Geneva: WHO, 2004. http://www.who.int/whr/2004/en/index.html (accessed June 12, 2007).
Murray HW, Berman JD, Davies CR, Saravia NG. Advances in leishmaniasis. Lancet 2005; 366: 1561–77.
Olliaro PL, Guerin PJ, Gerstl S, Haaskjold AA, Rottingen JA, Sundar S. Treatment options for visceral leishmaniasis: a systematic review of clinical studies done in India, 1980–2004. Lancet Infect Dis 2005; 5: 763–74.
Guerin PJ, Olliaro P, Sundar S, et al. Visceral leishmaniasis: current status of control, diagnosis, and treatment, and a proposed research and development agenda. Lancet Infect Dis 2002; 2: 494–501.
Desjeux P. Leishmaniasis. Nat Rev Mirobiol 2004; 2: 692.
Reithinger R, Mohsen M, Aadil K, Sidiqi M, Erasmus P, Coleman PG. Anthroponotic cutaneous leishmaniasis, Kabul, Afghanistan. Emerg Infect Dis 2003; 9: 727–29.
Davies CR, Reithinger R, Campbell-Lendrum D, Feliciangeli D, Borges R, Rodriguez N. The epidemiology and control of leishmaniasis in Andean countries. Cad Saúde Publica 2000; 16: 925–50.
