Ashkan Moslehi Mohammad, Rahim Kadivar Mohammad
Department of Pediatrics, Nemazee Hospital, Shiraz University of Medical Sciences, Shiraz, Iran.
Trop Doct. 2008 Jul;38(3):186-8. doi: 10.1258/td.2007.070259.
Kala-azar (visceral leishmaniasis [VL]) is endemic in southern Iran. We retrospectively evaluated 367 infants and children suffering from VL at hospitals affiliated to the Shiraz University of Medical Sciences in Fars Province, southwest Iran). Seasonal variations were observed with more cases presenting in late winter, spring and fewer in summer. The predominant clinical features in these patients were chronic fever, pallor, weight loss, abdominal distention and hepatosplenomegaly. Lymphadenopathy was less common. Common laboratory abnormalities included anaemia, leukopenia, thrombocytopenia, hypoalbuminaemia and hypergammaglobulinaemia. Liver function tests were deranged in two-thirds of the patients. The immunofluorescence antibody test was positive in all patients and all of them had a positive bone marrow smear or a culture for Leishmania donovani. Patients responded well to glucantim therapy with a cure rate of 96.7%. Relapse was observed in 8.2% (30). Mortality in this series was 7.3%. Twenty patients died during their therapy period. Jaundice and grossly deranged liver function tests were found to be bad prognostic signs.
黑热病（内脏利什曼病[VL]）在伊朗南部呈地方性流行。我们对伊朗西南部法尔斯省设拉子医科大学附属医院的367例患黑热病的婴幼儿及儿童进行了回顾性评估。观察到有季节变化，冬末和春季出现的病例较多，夏季较少。这些患者的主要临床特征为长期发热、面色苍白、体重减轻、腹胀及肝脾肿大。淋巴结病较少见。常见的实验室异常包括贫血、白细胞减少、血小板减少、低白蛋白血症及高球蛋白血症。三分之二的患者肝功能检查结果异常。所有患者的免疫荧光抗体试验均为阳性，且所有患者的骨髓涂片或杜氏利什曼原虫培养均呈阳性。患者对葡糖锑钠治疗反应良好，治愈率为96.7%。观察到8.2%（30例）复发。该系列的死亡率为7.3%。20例患者在治疗期间死亡。黄疸及严重异常的肝功能检查结果被发现是不良预后征象。
