A 50-year-old man came to the emergency room of a university hospital complaining of weight loss, fever and abdominal pain associated with hepatosplenomegaly. Laboratory investigations revealed pancytopenia with red blood cell (RBC) count of 2.35 × 1012/L, hemoglobin 7.2 g/dL (RBCs with rouleaux formation), platelets of 75.7 × 109/L, white blood cell count of 2.77 × 109/L (with 58% neutrophils, 27% lymphocytes, 15% monocytes, 0% eosinophils and 0% basophils), hypoalbuminemia (1.31 g/dL) and hypergammaglobulinemia (6.63 g/dL). Serological test results were negative for antibodies for hepatitis (B and C) and human immunodeficiency virus (HIV). Due to the laboratory findings and sustained pancytopenia, a bone marrow biopsy was performed which showed Leishmania amastigotes phagocytosed by macrophages (Figure 1) confirming the diagnosis of visceral leishmaniasis infection.11 Pagliano P, Esposito S. Visceral leishmaosis in immunocompromised host: an update and literature review. J Chemother. 2017;29(5):261-6.,22 Koster KL, Laws HJ, Troeger A, Meisel R, Borkhardt A, Oommen PT. Visceral leishmaniasis as a possible reason for pancytopenia. Front Pediatr. 2015;29(3):59.
References
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1Pagliano P, Esposito S. Visceral leishmaosis in immunocompromised host: an update and literature review. J Chemother. 2017;29(5):261-6.
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2Koster KL, Laws HJ, Troeger A, Meisel R, Borkhardt A, Oommen PT. Visceral leishmaniasis as a possible reason for pancytopenia. Front Pediatr. 2015;29(3):59.
Publication Dates
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Publication in this collection
15 Apr 2019 -
Date of issue
Jan-Mar 2019
History
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Received
12 Dec 2017 -
Accepted
20 June 2018