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Hemophagocytic lymphohistiocytosis in children with visceral leishmaniasis

Daniel Blázquez-Gamero1, Nerea Domínguez-Pinilla, Carmen Chicharro

  • 1From the *Pediatric Infectious Diseases and Immunodeficiencies Unit, 12 de Octubre University Hospital, Madrid, Spain; †Pediatric Hematology/Oncology Unit, 12 de Octubre University Hospital, Madrid, Spain; ‡WHO Collaborating Centre for Leishmaniasis, Servicio de Parasitología, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Madrid, Spain; §Department of Pediatrics, Fuenlabrada University Hospital, Fuenlabrada, Spain; ¶Pediatric Infectious Diseases Unit, Hospital Infantil Universitario Niño Jesús, Madrid, Spain; ‖Department of Pediatrics, Severo Ochoa University Hospital, Leganés, Spain; **Department of Pediatrics, Getafe University Hospital, Getafe, Spain; ††Department of Pediatrics, Móstoles University Hospital, Móstoles, Spain; and ‡‡Department of Pediatrics, Ramón y Cajal University Hospital, Madrid, Spain.

The Pediatric Infectious Disease Journal
|May 14, 2015
PubMed

Insights

Visceral leishmaniasis (VL) can cause acquired hemophagocytic lymphohistiocitosis (HLH) in children. This study found 41% of children with VL developed HLH, highlighting the need for VL screening in HLH cases from endemic regions.

Area of Science:

  • Pediatric Infectious Diseases
  • Hematology
  • Immunology

Background:

  • Acquired hemophagocytic lymphohistiocitosis (HLH) is a severe hyperinflammatory syndrome.
  • Visceral leishmaniasis (VL) is an emerging cause of secondary HLH, particularly in endemic areas.
  • The frequency of HLH in pediatric VL cases requires further investigation.

Purpose of the Study:

  • To determine the incidence of acquired hemophagocytic lymphohistiocitosis (HLH) in children diagnosed with visceral leishmaniasis (VL).
  • To assess the clinical significance of VL as a trigger for HLH in pediatric populations.

Main Methods:

  • A multicenter prospective study design was employed.
  • Twenty-four children diagnosed with visceral leishmaniasis (VL) were enrolled.
  • The development of HLH criteria was monitored in all participants.

Main Results:

  • A significant proportion of children with VL developed HLH syndrome.
  • Ten out of twenty-four (41%) pediatric VL patients met the criteria for HLH.
  • This indicates a high frequency of HLH complication in this cohort.

Conclusions:

  • Visceral leishmaniasis (VL) is a notable cause of acquired hemophagocytic lymphohistiocitosis (HLH) in children.
  • Healthcare providers should consider and rule out VL in children presenting with HLH, especially those from or residing in endemic regions.
  • Early diagnosis and management of VL may prevent or mitigate HLH development.

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