Serum neopterin concentrations during treatment of leishmaniasis: useful as test of cure?

Neopterin, a product of gamma-interferon-activated macrophages, was measure d in sera from 25 patients (12 patients with cutaneous leishmaniasis and 16 patients with visceral leishmaniasis) to determine the utility as a marker of disease activity and therapeutic efficacy. Patients originated from Ken ya (n = 5) and from the Academic Medical Center, Amsterdam, The Netherlands (n = 23). In seven patients follow-up sera after treatment were available. Two patients at the time of diagnosis of visceral leishmaniasis were co-in fected with HIV. The 12 patients with cutaneous leishmaniasis had serum neo pterin levels below the upper limit of the normal range. All 16 patients wi th visceral leishmaniasis had elevated levels of serum neopterin before tre atment. In six out of seven patients with visceral leishmaniasis followed d uring treatment neopterin levels decreased to values below the upper limit of the normal range (10 nmol l(-1)). Sequential measurements of serum neopt erin levels may be useful for monitoring therapeutic efficacy in patients w ith visceral leishmaniasis. (C) 2000 Federation of European Microbiological Societies. Published by Elsevier Science B.V. All rights reserved.