Leishmaniasis-Associated Hemophagocytic Syndrome Revisited: Not an Uncommon Clinical Presentation of Leishmaniasis

Abstract

Visceral leishmaniasis (VL) is an uncommon but important cause of reactive hemophagocytic syndrome (HS) that should be seriously considered in patients coming from endemic areas. We describe two cases of VL-associated HS; a young woman with fever, cytopenias and hyperferritinemia and an immunocompromised patient with fever, splenomegaly, hyperferritinemia and pancytopenia. The diagnosis of leishmaniasis was established with polymerase chain reaction for leishmania and bone marrow examination, whereas leihmaniasis specific treatment with liposomal amphotericin led to full clinical recovery and complete remission of HS. From the clinical point of view, it should be emphasized that the high clinical suspicion along with the use of modern, high yield diagnostic tools, may lead to early diagnosis of VL-associated HS, minimizing unnecessary hospitalization and potentially harmful investigations and treatments.




J Med Cases. 2012;3(5):315-318
doi: https://doi.org/10.4021/jmc715w