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Key Clinical Message: In this case of disseminated cutaneous leishmaniasis in our immunosuppressive patient who was a refractor to treatment with intra-lesion Glucantime® and systemic L-AmB, considering the good clinical response to oral miltefosine, this drug might be the best treatment option. Abstract: Diagnosis and treatment of leishmaniasis are challenging in immunosuppressed patients. Here, we report a 46-year-old male renal transplant recipient with disseminated cutaneous leishmaniasis presenting with multiple lesions on the face and upper extremities 15 years after transplant with a challenging course of treatment with meglumine antimoniate, liposomal amphotericin B, and miltefosine.
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OBJECTIVES: This study aimed to evaluate the relationships between serum levels of 25-hydroxyvitamin D (25(OH)D) and short-term blood pressure variability (BPV) in newly diagnosed hypertensive patients. METHODS: One hundred newly diagnosed patients with stage one essential hypertension were included and divided into two groups, the deficient and non-deficient groups, according to their 25(OH)D level. The blood pressure was recorded automatically by a portable ambulatory blood pressure monitor for 24â h. RESULTS: In the present study, there was no significant relationship between vitamin D levels and short-term BPV or other parameters derived from ambulatory blood pressure monitoring (ABPM) (Pâ >â 0.05). Age (râ =â 0.260, Pâ =â 0.009), serum phosphorus (râ =â 0.271, Pâ =â 0.007), and cholesterol levels (râ =â 0.310, Pâ =â 0.011) were positively correlated with 25(OH)D levels, while glomerular filtration rate (râ =â -0.232, Pâ =â 0.021) negatively correlated with vitamin D levels. There was no crude or adjusted relationship between the levels of 25(OH)D and any parameters of ABPM in multiple linear regression analysis. CONCLUSION: Although the relationship between vitamin D levels and cardiovascular diseases has been confirmed, vitamin D deficiency does not cause an increase in cardiovascular risk by influencing the short-term BPV or other parameters derived from ABPM.