Some patients with visceral leishmaniasis will develop the hemophagocytic syndrome (hemophagocytic lymphohistiocytosis).
The hemophagocytic syndrome is the result of a hyperinflammatory response with activation and proliferation of cytotoxic T-lymphocytes and macrophages with overproduction of cytokines.
Clinical features:
(1) persistent fever
(2) hepatosplenomegaly
Laboratory findings:
(1) evidence of leishmaniasis (direct detection of organisms, PCR, etc).
(2) liver dysfunction (abnormal liver function tests)
(3) pancytopenia
Biopsies show macrophages ingesting erythrocytes (hemophagocytosis).
Since the hemophagocytic syndrome can be caused by many conditions, it is important to exclude other causes.
To read more or access our algorithms and calculators, please log in or register.
