Clinical and Laboratory Findings of Visceral Leishmaniasis in Children Hospitalized in Mashhad, Northeastern Iran: A Twenty-Year Retrospective Study
Background: Over the last decade, a few cases of visceral leishmaniasis (VL) have been reported in some provinces of northeastern Iran. We aimed to investigate clinical and laboratory findings of VL among children who admitted to the pediatric ward in a referral hospital in Mashhad, northeastern Iran.
Methods: A retrospective study, between 1997 and 2017, was performed on the data sheet registered for children with confirmed VL at the referral Emam Reza Hospital in Mashhad. Hematological and biochemical profiles of the patients were analyzed.
Results: Thirty-five children with VL, confirmed by the presence of amastigotes of Leishmania in Giemsa stained smears of the bone marrow, had been recorded through 20 yr. The mean age of patients was 3.7±4 yr. The majority of the patients suffered from hepatosplenomegaly (100%, n=35/35), followed by prolonged fever and pallor (91%, n=32/35), weight loss (85%, n=30/35). The main laboratory findings were anemia (94.1%), leukopenia (52.9%) and thrombocytopenia (70.5%). Almost one-third (37.1%; 13/35) of VL patients inhabited in rural areas of the Bojnoord district as a known VL endemic focus in northeastern Iran.
Conclusion: Our preliminary data showed that the origin of VL is still in some districts other than Mashhad, where VL just will be diagnosed.
2. Leishmaniasis. Fact sheet [Internet]. Geneva: World Health Organization; 2019 (https://www.who.int/news-room/fact-sheets/detail/leishmaniasis, accessed 14 March 2019).
3. Alavi S, Fata A, Modarresi A. Retrospective study of visceral leishmaniosis during 14 years in Mashhad University of Medical Sciences. Univ Med Sci J. 2002; 45(75): 41-51.
4. Sah SP, Rijal S, Bhadani PP, et al. Visceral leishmaniasis in two cases of leukemia. Southeast Asian J Trop Med Public Health. 2002; 33(1): 25-7.
5. Varma N, Naseem S. Hematologic changes in visceral leishmaniasis/kala azar. Indian J Hematol Blood Transfus. 2010; 26(3):78-82.
6. Fakhar M, Asgari Q, Motazedian MH, et al. Medi-terranean visceral leishmaniasis associated with acute lymphoblastic leukemia (ALL). Parasitol Res.2008 ;103(2):473-5.
7. Daneshbod Y, Dehghani SJ, Daneshbod K. Bone marrow aspiration findings in kala-azar. Acta Cytol. 2010; 54(1): 12-24.
8. Moghaddas E, Fata A, Zarean M, et al. Investigation of visceral leishmamiasis among 192 dog carcasses killed by road accidents in Khorasan- e- Razavi during 2014- 2016. Iran J Public Health. 2018; 47:1742-1748.
9. Davies C, Gavgani AM. Age, acquired immunity and the risk of visceral leishmaniasis: a prospective study in Iran. Parasitology. 1999; 119(Pt 3): 247-257.
10. Asgari G, Fakhar M, Motazedian M, et al. Viseral leishmaniasis, an alarming rate of misdiagnosis (letter to editor). Iran Red Crescent Med J. 2007; 9(1): 45-47.
11. Gani ZH, Hassan MK, Jassim A-MH. Outcome of Hospitalized Children with Visceral Leishmaniasis in Basrah, Southern Iraq. MJBU. 2008; 26(2): 121-127.
12. Snider H, Lezama-Davila C, Alexander J, et al. Sex hormones and modulation of immunity against leishmaniasis. Neuroimmunomodulation. 2009;16(2):106-13.
13. Sarkari B, Naraki T, Ghatee MA, et al. Visceral leishmaniasis in southwestern Iran: A retrospective clinico-hematological analysis of 380 consecutive hospitalized cases (1999–2014). PloS One. 2016; 11(3): e0150406.
14. Daher EDF, de Sousa Soares D, Parente Filho SLA, et al. Hyponatremia and risk factors for death in human visceral leishmaniasis: new insights from a cross-sectional study in Brazil. BMC Infect Dis. 2017; 17(1):168.
15. Verde FAL, Verde FAAL, Neto AS, et al. Hormonal disturbances in visceral leishmaniasis (kala-azar). Am J Trop Med Hyg. 2011; 84(5):668-673.
16. Asfaram S, Pagheh A, Fakhar M, et al. Case Series of Visceral Leishmaniasis (kala-azar) in Mazandaran and Golestan Provinces, North of Iran. J Mazanda-ran Univ Med Sci. 2016; 26(144):373-81.
17. de Queiroz Sampaio MJA, Cavalcanti NV, Alves JGB, et al. Risk factors for death in children with visceral leishmaniasis. PLoS Negl Trop Dis. 2010; 4(11): e877.
18. Cascio A, Colomba C, Antinori S, et al. Pediatric visceral leishmaniasis in Western Sicily, Italy: a retrospective analysis of 111 cases. Eur J Clin Microbiol Infect Dis. 2002; 21(4): 277-282.
19. Asgari Q, Fakhar M, Motazedian H. Nomadic kala-azar in South of Iran. Iran J Public Health. 2006;35(3):85-6.
20. Torabi V, Mohebali M, Edrissian G, et al. Seroepi-demiological survey of visceral leishmaniasis by di-rect agglutination test in Bojnoord district, north Khorasan province in 2007. Iran J Epidemiol. 2009;4(3):43-50.
|Issue||Vol 15 No 4 (2020)|
|Visceral leishmaniasis Pediatrics Diagnosis Retrospective study Iran|
|Rights and permissions|
|This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.|