Nadrid A, Pousse H, Laradi-Chebil S, Khelif A, Bejaoui M, Besbes A, Radhouane M, Guediche M N
Service de pédiatrie, hôpital F-Bourguiba, Monastir, Tunisie.
Arch Pediatr. 1996 Sep;3(9):881-3. doi: 10.1016/0929-693x(96)87578-6.
Hemophagocytosis has already been reported in cases of visceral leishmaniasis and thus may complicate search for diagnosis.
A previously healthy 2 year-old boy was referred for fever and splenomegaly with pancytopenia. An initial diagnosis of kala-azar was refuted because of absence of biological inflammatory syndrome, negativity of bone-marrow aspiration and splenic ponction and of specific serology. After three months of clinical deterioration and apparition of active hemophagocytosis, both bone marrow aspiration and specific serology for visceral leishmaniasis became positive. The boy was given sodium stibogluconate for 20 days; he improved gradually with complete and definitive remission.
Diagnosis of visceral leishmaniasis may be difficult, even in countries where this condition is relatively frequent; the association with hemophagocytosis is possible and does not constitute a poor factor of prognosis if specific therapy is proposed.
噬血细胞现象已在内脏利什曼病病例中被报道，因此可能使诊断变得复杂。
一名此前健康的2岁男孩因发热、脾肿大伴全血细胞减少前来就诊。由于缺乏生物炎症综合征、骨髓穿刺和脾穿刺结果为阴性以及特异性血清学检查结果为阴性，最初的黑热病诊断被推翻。经过三个月的临床恶化以及出现活动性噬血细胞现象后，骨髓穿刺和内脏利什曼病的特异性血清学检查均变为阳性。该男孩接受了20天的葡萄糖酸锑钠治疗；他逐渐好转并实现了完全且最终的缓解。
即使在内脏利什曼病相对常见的国家，其诊断也可能存在困难；与噬血细胞现象相关是可能的，并且如果进行特异性治疗，并不构成不良预后因素。
