Hamwi Ali Othman, Mohammad Ali Abdallatif, Hamwi Sara Othman, Mohammad Razan Abdallatif, Shahin Kayss Younis
College of Medicine, University of Tartous, Tartous, Syrian Arab Republic.
Department of Rheumatology, Tishreen Hospital, Latakia, Syrian Arab Republic.
Avicenna J Med. 2020 Oct 13;10(4):223-226. doi: 10.4103/ajm.ajm_168_20. eCollection 2020 Oct-Dec.
Visceral leishmaniasis (VL) type in Syria is , a fatal incapacitating disease, which is mostly seen in infants.
Hospital records of 19 children with VL were retrospectively reviewed. The period of the study was from June 2016 to July 2019.
The median age of the patients was 45.5 months. None was coinfected with human immunodeficiency virus or known to be immunocompromised. Pallor and anemia were observed in all cases, fever in 13 (68.42%), splenomegaly in 18 (94.7%), hepatomegaly in 11 (57.9%), thrombocytopenia in 15 (78.95%), and leukopenia in nine (47.4%). A bone marrow aspirate was obtained and Leishmania amastigotes were detected in all patients. All patients were initially treated with meglumine antimonate; one child did not respond and was treated with lipid formulations of amphotericin B.
Presentation of VL in the pediatric age group is characterized by pallor, fever, splenomegaly, and hepatomegaly. Hematological and biochemical indices are typical with cytopenias. In all cases, microscopic examination provided a positive diagnosis. Despite recent reports on decreased responses to antimonial drugs of patients with Mediterranean VL, meglumine antimonate treatment appears to be still highly effective in Syria.
叙利亚的内脏利什曼病（VL）是一种致命的致残性疾病，多见于婴儿。
回顾性分析19例VL患儿的医院记录。研究时间为2016年6月至2019年7月。
患者的中位年龄为45.5个月。无一例合并人类免疫缺陷病毒感染或已知免疫功能低下。所有病例均观察到面色苍白和贫血，13例（68.42%）发热，18例（94.7%）脾肿大，11例（57.9%）肝肿大，15例（78.95%）血小板减少，9例（47.4%）白细胞减少。所有患者均进行了骨髓穿刺，均检测到利什曼原虫无鞭毛体。所有患者最初均接受葡甲胺锑酸盐治疗；1例患儿无反应，改用两性霉素B脂质体治疗。
儿童年龄组VL的表现特征为面色苍白、发热、脾肿大和肝肿大。血液学和生化指标典型，伴有血细胞减少。所有病例经显微镜检查均确诊。尽管最近有报道称地中海VL患者对锑剂的反应有所下降，但葡甲胺锑酸盐治疗在叙利亚似乎仍然非常有效。
