Un caso di eritrofagocitosi secondaria a leishmaniosi nell’entroterra friulano

The present report describes the case of a 2-year-old girl that lives in Northern Italy suffering from a one month lasting fever, pallor and hepatosplenomegaly. Serum testing showed pancytopenia, high levels of immunoglobulins, hypertriglyceridemia and hyperferritinemia. Secondary hemophagocytic lymphohistiocytosis was suspected on the basis of case history (a holiday in Southern Italy few months before, which is an endemic area for leishmaniasis, unlike the region where the child lives) and on clinical and laboratory findings. Bone marrow examination revealed active hemophagocytosis with intra and extracellular parasites. High levels of antibody title for leishmaniasis confirmed the final diagnosis of hemophagocytic syndrome associated with visceral leishmaniasis. Treatment with liposomal amphotericin B resulted in dramatic resolution of all signs and symptoms within few days.