Departments of Pediatrics.
Department of Pediatrics, Democritus University of Thrace Faculty of Medicine, Alexandroupolis, Greece.
J Pediatr Hematol Oncol. 2021 Mar 1;43(2):e223-e226. doi: 10.1097/MPH.0000000000001747.
We present the case of a 7-year-old boy who fulfilled the diagnostic criteria for hemophagocytic lymphohistiocytosis (HLH). Prompt visualization of his bone marrow confirmed the diagnosis of visceral leishmaniasis (VL). He responded well to treatment with liposomal amphotericin-B. The patient had a false-negative enzyme-linked immunosorbent assay for Leishmania infantum and a false-positive immunoglobulin M test for Epstein Barr virus (EBV). Because age at presentation is similar in children with VL and familial HLH for whom EBV is the usual trigger, ruling out VL is extremely important because nonspecific serologic tests for EBV can lead to the inappropriate diagnosis of EBV-driven primary HLH and to the administration of unnecessary immunochemotherapy.
我们报告了一例 7 岁男孩，其符合噬血细胞性淋巴组织细胞增生症 (HLH) 的诊断标准。骨髓的快速可视化结果证实了内脏利什曼病 (VL) 的诊断。他对脂质体两性霉素 B 的治疗反应良好。该患者利什曼原虫婴儿酶联免疫吸附试验结果为阴性，EB 病毒免疫球蛋白 M 试验结果为阳性。由于 VL 和家族性 HLH 患儿的发病年龄相似，而 EBV 是常见的触发因素，因此排除 VL 极为重要，因为 EBV 的非特异性血清学检测可能导致 EBV 驱动的原发性 HLH 的不当诊断，并导致不必要的免疫化学治疗。
