ECG manifestations of meglumine antimoniate in treatment of cutaneous leishmaniasis

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 1 st 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.

[1]  Gabriel Dunya,et al.  Head and neck cutaneous leishmania: clinical characteristics, microscopic features and molecular analysis in a cohort of 168 cases , 2016, European Archives of Oto-Rhino-Laryngology.

[2]  O. Abbas,et al.  Cutaneous Leishmaniasis: An Overlooked Etiology of Midfacial Destructive Lesions , 2016, PLoS neglected tropical diseases.

[3]  A. Loya,et al.  Caseating Granulomas in Cutaneous Leishmaniasis , 2014, PLoS neglected tropical diseases.

[4]  R. Ullah,et al.  PCR and Microscopic Identification of Isolated Leishmania tropica from Clinical Samples of Cutaneous Leishmaniasis in Human Population of Kohat Region in Khyber Pakhtunkhwa , 2014, BioMed research international.

[5]  K. Andrews,et al.  Drug repurposing and human parasitic protozoan diseases , 2014, International journal for parasitology. Drugs and drug resistance.

[6]  M. Farman,et al.  ELECTROCARDIOGRAPHIC CHANGES DURING TREATMENT WITH CUTANEOUS LEISHMANIASIS , 2013 .

[7]  A. Haque,et al.  HDAC inhibitors in parasitic diseases , 2012, Immunology and cell biology.

[8]  S. Sundar,et al.  Treatment options for visceral leishmaniasis: a systematic review of clinical studies done in India, 1980-2004. , 2005, The Lancet. Infectious diseases.

[9]  J. Berman,et al.  Advances in leishmaniasis , 2005, The Lancet.

[10]  P. Coleman,et al.  Anthroponotic Cutaneous Leishmaniasis, Kabul, Afghanistan , 2003, Emerging infectious diseases.

[11]  Shyam Sundar,et al.  Visceral leishmaniasis: current status of control, diagnosis, and treatment, and a proposed research and development agenda. , 2002, The Lancet. Infectious diseases.

[12]  D. Campbell-Lendrum,et al.  The epidemiology and control of leishmaniasis in Andean countries. , 2000, Cadernos de saude publica.

[13]  J. Aguirre-Urizar,et al.  Mucocutaneous leishmaniasis must be included in the differential diagnosis of midline destructive disease: two case reports. , 2015, Oral surgery, oral medicine, oral pathology and oral radiology.