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[Kala-azar originating in Ischia].
1III. Medizinische Klinik, Universität Heidelberg.
Deutsche Medizinische Wochenschrift (1946)
|October 2, 1987
Summary
This case study details a patient with Kala-Azar (Leishmania donovani infection) who experienced symptoms mimicking multiple myeloma. Successful treatment with sodium stibogluconate resolved the parasitic infection and associated hematological abnormalities.
Area of Science:
- Infectious Diseases
- Hematology
- Parasitology
Background:
- Kala-azar, caused by Leishmania donovani, is a severe parasitic disease.
- Diagnosis can be challenging due to overlapping symptoms with other conditions.
- Understanding the hematological manifestations is crucial for effective management.
Observation:
- A 53-year-old man presented with nocturnal sweating, fever, malaise, and hepatosplenomegaly post-travel.
- Bone marrow and liver biopsies confirmed Leishmania donovani infection.
- Key findings included plasma cell hyperplasia, lymphoplasmocytoid wash-out, and polyclonal IgG hypergammaglobulinemia.
Findings:
- Initial treatment with pentamidine was ineffective.
- Two courses of sodium stibogluconate led to disease regression.
- Persistent hypergammaglobulinemia and hyperproteinemia resolved slowly.
Implications:
- Plasma cell hyperplasia and hypergammaglobulinemia in Kala-azar can mimic multiple myeloma.
- These hematological changes are attributed to the chronic parasitic infection stimulating antibody production.
- Storage-cell hyperplasia may contribute to leukopenia and thrombocytopenia in visceral leishmaniasis.
