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Several epidemiological studies have proposed that sex hormones may account for the increased susceptibility of males towards infectious diseases, including leishmaniasis; however, the role of testosterone and sex bias, if any, in <jats:styled-content style=\"fixed-case\">PKDL<\/jats:styled-content> has not been evaluated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The study population included 87 patients with <jats:styled-content style=\"fixed-case\">PKDL<\/jats:styled-content> and 39 with <jats:styled-content style=\"fixed-case\">VL<\/jats:styled-content>; levels of testosterone were measured by competitive enzyme\u2010linked immunosorbent assay along with their levels of antileishmanial immunoglobulin and IgG. The association of testosterone, if any, was then correlated with age, gender, humoral response, lesional profile, disease duration, and lag period.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A male predominance was evident in <jats:styled-content style=\"fixed-case\">PKDL<\/jats:styled-content>, not in <jats:styled-content style=\"fixed-case\">VL<\/jats:styled-content>; importantly, this male bias was predominant postpubertal, strongly indicative of an association between sex hormone and disease progression. Male patients with <jats:styled-content style=\"fixed-case\">PKDL<\/jats:styled-content> had significantly higher levels of testosterone, which regressed significantly with miltefosine, not with sodium antimony gluconate. Additionally, a significant correlation was found between plasma testosterone and antileishmanial IgG.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Taken together, our study has established a male dominance in <jats:styled-content style=\"fixed-case\">PKDL<\/jats:styled-content>, which showed a strong association with testosterone. This information should be taken into consideration for disease monitoring and control.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ijd.13048","type":"journal-article","created":{"date-parts":[[2015,11,4]],"date-time":"2015-11-04T21:23:09Z","timestamp":1446672189000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":26,"title":["A male preponderance in patients with Indian post kala\u2010azar dermal leishmaniasis is associated with increased circulating levels of testosterone"],"prefix":"10.1111","volume":"55","author":[{"given":"Debanjan","family":"Mukhopadhyay","sequence":"first","affiliation":[{"name":"Department of Pharmacology Institute of Post Graduate Medical Education and Research Kolkata India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shibabrata","family":"Mukherjee","sequence":"additional","affiliation":[{"name":"Department of Pharmacology Institute of Post Graduate Medical Education and Research Kolkata India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susmita","family":"Ghosh","sequence":"additional","affiliation":[{"name":"Department of Pharmacology Institute of Post Graduate Medical Education and Research Kolkata India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susmita","family":"Roy","sequence":"additional","affiliation":[{"name":"Department of Pharmacology Institute of Post Graduate Medical Education and Research Kolkata India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bibhuti","family":"Saha","sequence":"additional","affiliation":[{"name":"Department of Tropical Medicine Calcutta School of Tropical Medicine Kolkata India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nilay Kanti","family":"Das","sequence":"additional","affiliation":[{"name":"Department of Dermatology Calcutta Medical College Kolkata India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mitali","family":"Chatterjee","sequence":"additional","affiliation":[{"name":"Department of Pharmacology Institute of Post Graduate Medical Education and Research Kolkata India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2015,11,4]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.0141-9838.2004.00710.x"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1038\/nri2394"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.it.2013.10.006"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0066229"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/jit610"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0062390"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(03)00517-6"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-4632.2010.04558.x"},{"key":"e_1_2_6_10_1","first-page":"480","article-title":"Deception and manipulation: the arms of Leishmania, a successful parasite","volume":"5","author":"Cec\u00edlio P","year":"2014","journal-title":"Front Immunol"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.4269\/ajtmh.2007.76.1125"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1159\/000180265"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1179\/000349802125002211"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.4269\/ajtmh.2012.11-0467"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pntd.0001433"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.4269\/ajtmh.12-0711"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1086\/588387"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/jir551"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.trstmh.2012.07.005"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.4103\/0378-6323.148562"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.4269\/ajtmh.2011.10-0590"},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-3156.2012.03067.x"},{"key":"e_1_2_6_23_1","doi-asserted-by":"publisher","DOI":"10.1590\/S0365-05962011000100007"},{"key":"e_1_2_6_24_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1346-8138.2010.01139.x"},{"key":"e_1_2_6_25_1","doi-asserted-by":"publisher","DOI":"10.1128\/IAI.70.5.2288-2296.2002"},{"key":"e_1_2_6_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2214-109X(14)70318-3"},{"key":"e_1_2_6_27_1","first-page":"341","article-title":"Ten years of kala\u2010azar in west Bengal, Part I. 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