Visceral leishmaniasis and haemophagocytic syndrome in an Omani child

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...

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Bibliographic Details
Main Authors: Khalfan Al Sineidi, Yasser A. Wali, Zakia Al Lamki, Anil V. Pathare
Format: Article
Language:English
Published: Sultan Qaboos University 2002-04-01
Series:Sultan Qaboos University Medical Journal
Subjects:
Online Access:https://journals.squ.edu.om/index.php/squmj/article/view/1235
Description
Summary: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.
ISSN:2075-051X
2075-0528