一名埃塞俄比亚 HIV 患者出现严重的黑热病后皮肤利什曼病，米替福新治疗有效。
Severe post-kala-azar dermal leishmaniasis successfully treated with miltefosine in an Ethiopian HIV patient.
机构信息
Médecins Sans Frontières - Holland, Yeke Subcity, Woreda 7, Kebele 11/12, House #605, Balderas (in front of Levi Building), P.O BOX 34357, Addis Ababa, Ethiopia.
Médecins Sans Frontières - Holland, Yeke Subcity, Woreda 7, Kebele 11/12, House #605, Balderas (in front of Levi Building), P.O BOX 34357, Addis Ababa, Ethiopia; Institute of Tropical Medicine, Nationalestraat 115, B-2000, Antwerp, Belgium.
出版信息
Int J Infect Dis. 2019 Apr;81:221-224. doi: 10.1016/j.ijid.2019.02.012. Epub 2019 Feb 18.
Post-kala-azar dermal leishmaniasis (PKDL) is a neglected tropical disease characterized by a dermatosis which often appears after successful treatment of visceral leishmaniasis caused by Leishmania donovani. PKDL treatment options are few and have severe limitations. In East-Africa, the standard treatment of PKDL is with daily painful potentially toxic sodium stibogluconate injections, administered for a prolonged duration of 30-60 days. In the Indian subcontinent, PKDL is mainly treated with miltefosine, a safer orally administered drug. However, in East-Africa, there is very limited experience in the use of miltefosine for treatment of severe PKDL, with only one published case report. Here we report a severe PKDL case in an Ethiopian HIV patient successfully treated with oral miltefosine (100mg/day for 28 days). Miltefosine was efficacious, safe and well tolerated, suggesting that it can play an important role in the treatment of severe PKDL also in East-African patients. Further research is warranted.
皮肤利什曼病（PKDL）是一种被忽视的热带病，其特征是一种皮肤病，通常在成功治疗由利什曼原虫引起的内脏利什曼病后出现。PKDL 的治疗选择很少，且具有严重的局限性。在东非，PKDL 的标准治疗是每天使用疼痛且潜在毒性的葡萄糖酸锑钠注射，持续 30-60 天。在印度次大陆，PKDL 主要用米替福新治疗，这是一种更安全的口服药物。然而，在东非，使用米替福新治疗严重 PKDL 的经验非常有限，仅有一例已发表的病例报告。在此，我们报告了一例成功用口服米替福新（100mg/天，共 28 天）治疗的埃塞俄比亚 HIV 患者的严重 PKDL 病例。米替福新有效、安全且耐受性良好，这表明它在东非患者严重 PKDL 的治疗中也能发挥重要作用。需要进一步研究。
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