Visceral leishmaniasis and haemophagocytic syndrome in an Omani child
Journal Title: Sultan Qaboos University Medical Journal - Year 2002, Vol 4, Issue 1
Abstract
The paper reports the case of a previously healthy 4-year-old-girl who presented with pallor, fever and hepatosplenomegaly. Laboratory findings included pancytopenia, hypertriglyceridemia and hyperferritinemia. Initial diagnosis of kala-azar could not be confirmed because of the absence of clinical evidence, negativity of bone marrow aspiration or specific serology for visceral leishmaniasis. Repeated marrow aspiration, performed due lack of clinical response, revealed histiocytes showing haemophagocytosis consistent with haemophagocytic lymphohistocytosis (HLH) and appropriate treatment was started. She continued to have high-grade fever, and a third bone marrow aspiration ultimately revealed presence of Leishmania amastigotes with evidence of active haemophagocytosis. The girl was treated with liposomal amphotericin (AmBisome) for 5 days, following which she recovered rapidly with definitive remission.
Authors and Affiliations
Khalfan Al Sineidi| Department of Child Health (Haematology/Oncology Unit), College of Medicine & Health Sciences, Sultan Qaboos University, P.O.Box: 35, Al Khod-123, Sultanate of Oman. Department of Haematology, Sultan Qaboos University Hospital, P.O.Box: 38, Al Khod-123, Sultanate of Oman, Yasser A. Wali| Department of Child Health (Haematology/Oncology Unit), College of Medicine & Health Sciences, Sultan Qaboos University, P.O.Box: 35, Al Khod-123, Sultanate of Oman. Department of Haematology, Sultan Qaboos University Hospital, P.O.Box: 38, Al Khod-123, Sultanate of Oman, Anil V. Pathare| Department of Child Health (Haematology/Oncology Unit), College of Medicine & Health Sciences, Sultan Qaboos University, P.O.Box: 35, Al Khod-123, Sultanate of Oman. Department of Haematology, Sultan Qaboos University Hospital, P.O.Box: 38, Al Khod-123, Sultanate of Oman, Zakia Al Lamki| Department of Child Health (Haematology/Oncology Unit), College of Medicine & Health Sciences, Sultan Qaboos University, P.O.Box: 35, Al Khod-123, Sultanate of Oman. Department of Haematology, Sultan Qaboos University Hospital, P.O.Box: 38, Al Khod-123, Sultanate of Oman
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