|IMAGE IN HEMATOLOGY
|Year : 2015 | Volume
| Issue : 2 | Page : 91
Leishmania associated with hemophagocytosis
Shahad Barri1, Roaa Zailaie2, Suliman Al Jumaah2
1 Department of Pathology, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
2 Department of Pediatric, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
|Date of Web Publication||7-Jul-2015|
Department of Pathology, King Faisal Specialist Hospital and Research Center, Riyadh
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Barri S, Zailaie R, Jumaah SA. Leishmania associated with hemophagocytosis. J Appl Hematol 2015;6:91
A 6-month-old boy from the southern region of Saudi Arabia presented to our hospital due to fever, persistent thrombocytopenia, pallor, and hepatosplenomegaly for 1-month. He had a history of pulmonary valve stenosis, which required repair at the age of 5 weeks. He had no history of any other illnesses.
During presentation at local hospital, he was worked up and found to have high leishmania titer for which he was treated with liposomal amphotericin B for 10 days and he responded by decreased in his fever and hepatosplenomegaly, however, due to persistent thrombocytopenia and the slight hepatosplenomegaly he was referred to our hospital for further investigation that was done and revealed negative leishmania titer with leukocytosis and thrombocytopenia. Erythrocyte sedimentation rate, C-reactive protein, ferritin, and tri-glyceride were elevated, liver function test showed elevated AST. Kidney function test and autoimmune work up were normal, blood culture and urine analysis were negative, soluble receptor α for IL-2 was negative. US Abdomen show mild to moderate splenomegaly with no focal lesion and prominent pancreas with per pancreatic few small lymph nodes. Evaluation of bone marrow showed some hemophagocytic cells [Figure 1] and few histiocytes with Leishmania donovani bodies [Figure 2], which was consistent with hemophagocytic lymphohistiocytosis secondary to visceral leishmaniasis.
|Figure 2: Bone marrow aspiration showing histiocyte with Leishmania donovani bodies|
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[Figure 1], [Figure 2]