Clinico-Hematological Findings of Acute Pediatric Visceral Leishmaniasis Referred to the Northeast of Iran during 2005-2015

Background: to characterize the epidemiological, clinical, hematological and biochemical features of 33 cases hospitalized with pediatric visceral leishmaniasis (pvl) in north khorasan province of iran from 2005 to 2015. methods: the serological, hematological and biochemical tests were employed in 33 children between 8 months to 6 yr with a final diagnosis of acute visceral leishmaniasis (vl). the diagnosis of vl was established by microscopic demonstration of leishmania spp. amastigotes inactive bone marrow aspiration (bma). results: the most common presenting features were anemia (82.5%), fever (75%), and hepatosplenomegaly (45.4%). various hematological parameters showed that most patients were suffering from moderate to severe microcytic hypochromic anemia (78.8% had rbc count less than 4 million cells/ul, 67.7% hb less than 8 fl). 66.7% of them were leukopenic (wbc: less than 5× 103 /μl) and 24.2% had decreased platelet counts. pancytopenia was observed in 18.2% of cases. mcv, mch, and mchc levels were below the reference range in 88%, 90% and 85.1% of the patients respectively. moreover, aspartate transaminase (ast) and alanine transaminase (alt) levels were increased in 53.33% and 6.66% of the patients respectively. 92.9% of cases were c-reactive protein (crp) positive. bone marrow was found hyper-cellular in all of them, and myeloid to erythroid ratio (m/e) was more than 4 in 39.1% of cases. plasma cells slightly were increased in 60% of patients and megakaryocytes were decreased in thrombocytopenic patients. conclusion: bone marrow/splenic aspiration still remains the gold standard test despite its risk and pain for patients.