{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,3]],"date-time":"2026-02-03T15:57:07Z","timestamp":1770134227385,"version":"3.49.0"},"reference-count":43,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2011,5,5]]},"abstract":"<jats:p>This study presents a cross-sectional analysis of the hormonal alterations of patients with visceral leishmaniasis. The diagnosis was established by the bone marrow aspiration and polymerase chain reaction test. Primary adrenal insufficiency was observed in 45.8% of patients; low aldosterone\/renin plasma ratio in 69.4%; low daily urinary aldosterone excretion in 61.1%; and low transtubular potassium gradient in 68.0%. All patients had normal plasma antidiuretic hormone (ADH) concentrations, hyponatremia, and high urinary osmolality. Plasma parathyroid hormone was low in 63%; hypomagnesemia was present in 46.4%, and increased Mg<jats:sup>++<\/jats:sup><jats:sub>EF<\/jats:sub> in 100%. Primary thyroid insufficiency was observed in 24.6%, and secondary thyroid insufficiency in 14.1%. Normal follicle-stimulating hormone plasma levels were present in 81.4%; high luteinizing hormone and low testosterone plasma levels in 58.2% of men. There are evidences of hypothalamus-pituitary-adrenal axis abnormalities, inappropriate aldosterone and ADH secretions, and presence of hypoparathyroidism, magnesium depletion, thyroid and testicular insufficiencies.<\/jats:p>","DOI":"10.4269\/ajtmh.2011.09-0171","type":"journal-article","created":{"date-parts":[[2011,5,3]],"date-time":"2011-05-03T18:53:58Z","timestamp":1304448838000},"page":"668-673","source":"Crossref","is-referenced-by-count":20,"title":["Hormonal Disturbances in Visceral Leishmaniasis (Kala-Azar)"],"prefix":"10.4269","volume":"84","author":[{"given":"Frederico","family":"Araujo Lima Verde","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francisco","family":"Agenor Araujo Lima Verde","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Augusto Saboia","family":"Neto","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paulo C\u00e9sar","family":"Almeida","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emir","family":"Mendon\u00e7a Lima Verde","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2795","reference":[{"key":"R1","series-title":"Trata-do de Infectologia","first-page":"1561","author":"Badar\u00f3","year":"2007"},{"key":"R2","series-title":"J Bras Neurol","first-page":"172","article-title":"Dist\u00farbios \u00e1cido-base na leishmaniose visceral","volume":"30","author":"Lima Verde","year":"2008"},{"key":"R3","series-title":"Am J Pathol","first-page":"147","article-title":"The histopathology of kala-azar in the hamster, monkey and man","volume":"1","author":"Meleney","year":"1925"},{"key":"R4","series-title":"Hospital","first-page":"591","article-title":"On the pathology of viseral leishmaniasis (Leishmania donovani)","volume":"20","author":"Bogliolo","year":"1941"},{"key":"R5","series-title":"Front Neuroendocrinol","first-page":"321","article-title":"Regulation of pituitary ACTH secretion during chronic stress","volume":"15","author":"Aguilera","year":"1994"},{"key":"R6","series-title":"Endocr Rev","first-page":"164","article-title":"Alterations in thyroid function in patients with systemic illness: the euthyroid sick syndrome","volume":"3","author":"Wartofsky","year":"1982"},{"key":"R7","series-title":"Neuroendocrinology","first-page":"183","article-title":"Relation between the hypothalamic-pituitary-thyroid (HPT) axis and the hypotalamic-pituitary-adrenal (HPA) axis during repeated stress","volume":"81","author":"Helmreich","year":"2005"},{"key":"R8","series-title":"J Soc Biol","first-page":"89","article-title":"Interactions between the immune and neuroendocrine systems: clinical implications","volume":"197","author":"Gaillard","year":"2003"},{"key":"R9","series-title":"Williams Textbook of Endocrinology","first-page":"517","author":"Orth","year":"1998"},{"key":"R10","series-title":"J Clin Endocrinol Metab","first-page":"217","article-title":"Plasma corticosteroids in hiperreninemic hypoaldosteronism: evidence for diffuse impairment of the zona glomerulosa","volume":"57","author":"Stern","year":"1982"},{"key":"R11","series-title":"J Clin Endocrinol Metab","first-page":"867","article-title":"Hiporreninemic hipoaldosteronism in the critically ill: a new entity","volume":"53","author":"Zipser","year":"1981"},{"key":"R12","series-title":"Am J Nephrol","first-page":"360","article-title":"Renal potassium handling during states of low aldosterone bioactivity: a method to differentiate renal and non renal causes","volume":"7","author":"Zettel","year":"1997"},{"key":"R13","series-title":"J Clin Invest","first-page":"1512","article-title":"Hyperreninemic hypoaldosteronismus after chronic stress in the rat","volume":"96","author":"Aguirela","year":"1995"},{"key":"R14","series-title":"Med Clin North Am","first-page":"211","article-title":"The endocrine response to critical illness","volume":"79","author":"Rolih","year":"1995"},{"key":"R15","series-title":"Rev Inst Med Trop S\u00e3o Paulo","first-page":"253","article-title":"Hyponatremia in visceral leishmaniasis","volume":"52","author":"Lima Verde","year":"2010"},{"key":"R16","series-title":"Hyponatremia. 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