[Hematologic abnormalities in infantile visceral leishmaniasis]

Area of Science:

• Hematology
• Infectious Diseases
• Pediatrics

Context:

• Visceral leishmaniasis (VL) diagnosis can be challenging due to overlapping clinical and hematological features.
• Infantile VL often presents with non-specific symptoms that mimic other blood disorders.
• Early identification of hematological abnormalities is crucial for timely VL diagnosis in children.

Purpose:

• To investigate and document the spectrum of hematologic abnormalities in children diagnosed with visceral leishmaniasis.
• To correlate clinical findings with specific hematological changes in infantile VL.
• To highlight the diagnostic utility of recognizing hematological patterns in suspected VL cases.

Summary:

• A study of 35 children with infantile visceral leishmaniasis revealed universal anemia, with prevalent leukopenia (51%), thrombocytopenia (48%), and pancytopenia (36%).
• Bone marrow examination confirmed Leishman bodies and showed megakaryocyte abnormalities, dysgranulopoiesis (31%), and varied erythroid findings (hypoplasia 3%, hyperplasia 34%, dyserythropoiesis 71%).
• Hemophagocytosis (6%) and multiple dysplasias (9%) were also noted, underscoring the complex hematological impact of VL.

Impact:

• Understanding these hematological manifestations can guide clinicians toward prompt bone marrow smear examination for Leishman bodies.
• This knowledge facilitates earlier diagnosis of infantile visceral leishmaniasis, potentially avoiding more complex diagnostic procedures.
• Improved diagnostic efficiency can lead to earlier treatment initiation and better patient outcomes in pediatric VL.