Kala-Azar and leukemia: A rare association

Area of Science:

• Infectious Diseases
• Hematology
• Immunology

Background:

• Visceral leishmaniasis (VL) is a severe parasitic disease affecting macrophages in the liver, spleen, and bone marrow.
• Common clinical signs include fever, splenomegaly, and anemia, alongside hematologic abnormalities like leucopenia and thrombocytopenia.
• These hematologic findings in VL can overlap with other blood disorders, complicating diagnosis.

Observation:

• This case study presents a 12-year-old male diagnosed with hemophagocytic lymphohistiocytosis secondary to Kala-azar (visceral leishmaniasis).
• The patient was undergoing maintenance therapy for acute lymphoblastic leukemia (ALL) and was in remission at the time of VL diagnosis.
• The co-occurrence of VL and ALL highlights diagnostic challenges due to similar clinical and hematologic presentations.

Findings:

• Hemophagocytic lymphohistiocytosis (HLH) was diagnosed in a pediatric patient with a history of acute lymphoblastic leukemia.
• The HLH was attributed to Kala-azar (visceral leishmaniasis), underscoring the potential for opportunistic infections in immunocompromised individuals.
• The case emphasizes the diagnostic difficulty of VL when presenting with overlapping hematologic abnormalities.

Implications:

• Accurate and timely diagnosis of visceral leishmaniasis is critical, particularly in endemic areas and in patients with hematologic conditions.
• Recognizing VL as a potential cause of hemophagocytic lymphohistiocytosis is important for appropriate management.
• Prompt treatment of visceral leishmaniasis can be life-saving, preventing fatal outcomes in vulnerable patient populations.