Hemophagocytic Syndrome Associated with Visceral Leishmaniasis: Report of Two Cases

Visceral leishmaniasis is a systemic infection of the reticuloendothelial system caused by protozoan parasites of the genus Leishmania. It may mimic or lead to several types of hematological disorders including hemophagocytosis. Hemophagocytic syndrome associated with visceral leishmaniasis is an extremely rare clinicopathological entitiy. This condition is often difficult to diagnose, so treatment is often delayed. In this article, two pediatric cases who were admitted with prolonged fever, hepatosplenomegaly and pancytopenia are presented. Laboratory testing of these patients also showed hyperferritinemia and hypofibrinogenemia. Bone marrow examination revealed hemophagocytosis and Leishmania amastigotes. Treatment with the pentavalant antimonials resulted in a dramatic resolution of all signs and symptoms within a few days.