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Year : 2018  |  Volume : 9  |  Issue : 2  |  Page : 68-71

Leishmaniasis presenting as myelodysplasia: A diagnostic dilemma

Department of Pathology, Maulana Azad Medical College, New Delhi, India

Correspondence Address:
Dr. Richa Gupta
Department of Pathology, Room No. 263, Maulana Azad Medical College, Bahadur Shah Zafar Marg, New Delhi - 110 002
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/joah.joah_53_17

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Kala azar is a chronic parasitic infection which usually presents with fever, splenomegaly, and pancytopenia. Here is a case of a 9-month-old girl who presented with history of repeated blood transfusions for 3 months and later with fever and splenomegaly. Complete blood count showed bicytopenia with significant dysplasia seen in marrow aspiration smears. Secondary causes of dysplasia such as vitamin deficiency, drugs and toxins, and viral infections were ruled out and the patient was advised cytogenetic study to rule out refractory cytopenia of childhood. Subsequently, RK39 antigen result came out to be positive, and on reexamination, the slides showed few amastigote forms of Leishmania donovani. Hence, a diagnosis of Leishmaniasis with secondary dysplasia was made. Some cases may have the classic clinical features of LD infection although it has been emphasized here that myelodysplasia is a relatively uncommon presentation of LD infection. Hence, serological tests for Leishmania should be carried out along with a careful search for the parasite in all smears to avoid a grave diagnosis of myelodysplastic syndrome.

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