A 50-year-old man came to the emergency room of a university hospital complaining of weight loss, fever and abdominal pain associated with hepatosplenomegaly. Laboratory investigations revealed pancytopenia with red blood cell (RBC) count of 2.35×1012/L, hemoglobin 7.2g/dL (RBCs with rouleaux formation), platelets of 75.7×109/L, white blood cell count of 2.77×109/L (with 58% neutrophils, 27% lymphocytes, 15% monocytes, 0% eosinophils and 0% basophils), hypoalbuminemia (1.31g/dL) and hypergammaglobulinemia (6.63g/dL). Serological test results were negative for antibodies for hepatitis (B and C) and human immunodeficiency virus (HIV). Due to the laboratory findings and sustained pancytopenia, a bone marrow biopsy was performed which showed Leishmania amastigotes phagocytosed by macrophages (Figure 1) confirming the diagnosis of visceral leishmaniasis infection.1,2
Informação da revista
Vol. 41. Núm. 1.
Páginas 99-100 (janeiro - março 2019)
Vol. 41. Núm. 1.
Páginas 99-100 (janeiro - março 2019)
Images in Clinical Hematology
Open Access
Visceral leishmaniasis: amastigotes in the bone marrow
Visitas
6854
Thiago Rodrigo de Noronha, Ricardo Ambrósio Fock
Autor para correspondência
hemato@usp.br
Corresponding author. Clinical Laboratory Division, Pharmacy and Clinical Laboratory Department, University Hospital, University of São Paulo. Av. Lineu Prestes, 2565. São Paulo, SP, Brazil. CEP: 05508-900. Tel.: +55 11 3091 3639..
Corresponding author. Clinical Laboratory Division, Pharmacy and Clinical Laboratory Department, University Hospital, University of São Paulo. Av. Lineu Prestes, 2565. São Paulo, SP, Brazil. CEP: 05508-900. Tel.: +55 11 3091 3639..
Hospital Universitário da Universidade de São Paulo (HU USP), São Paulo, SP, Brazil
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References
[1]
P. Pagliano, S. Esposito.
Visceral leishmaosis in immunocompromised host: an update and literature review.
J Chemother, 29 (2017), pp. 261-266
[2]
K.L. Koster, H.J. Laws, A. Troeger, R. Meisel, A. Borkhardt, P.T. Oommen.
Visceral leishmaniasis as a possible reason for pancytopenia.
Front Pediatr, 29 (2015), pp. 59
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