• Attia iqbal cpsp karachi
  • Noor-ul-ain Qazi
  • Saima Gillani Department of Paedicatrics, Ayub Medical College, Abbottabad, Pakistan
  • Saad Hussain fauji foundation hospital mansehra
  • Muhammad Ali Raza Ayub teaching hospital Abbottabad, pediatrics department.
  • Jaweria Ajmal Student, AJK Medical College, Muzafarabad
Keywords: Children, Pancytopenia, Visceral Leishmaniasis, Bone marrow biopsy, Leishmania donovani


Background: Visceral leishmaniasis (VL) is a parasitic infection caused by Leishmania donovani. The sting of a sand-fly transmits Leishmania to humans. VL can lead to morbidity and even death if there is a delay in diagnosis. The objective of this study was to find out patients with visceral leishmaniasis presenting as pancytopenia in paediatric population. Methods: This single centre-cross sectional study was conducted for eight months in Paediatric Department, Ayub Medical Complex Hospital, Abbottabad. After taking informed written consent from all patients fulfilling the inclusion criteria, history was taken, detailed clinical examination done and bone marrow biopsy performed to check the Leishmania Donovani (LD) in the marrow sample. The findings were recorded and analysed. Results: Among 159 children presenting with pancytopenia, VL was confirmed in bone marrow biopsy report of 21 (13.2%) children, 100 children (62.9%) were males and 59 (37.1%) were females with the mean age of 5.58±3.44 years. Conclusion: VL is not an uncommon cause of pancytopenia in the paediatric population and should always be considered in the aetiology of pancytopenia in children especially those belonging to risky areas and if travel history is positive for the Mediterranean area. As the condition is treatable and has many complications that may lead to death if diagnosis is delayed, so workup and management done in time can actually save life of patient.

Pak J Physiol 2022;18(1):13‒5


Mansuri B, Thekdi KP. A prospective study among cases of the pancytopenia on the basis of clinic-hematological analysis and bone marrow aspiration. Int J Res Med Sci 2017;5:3545-9.

Tofighi Naeem A, Mahmoudi S, Saboui F, Hajjaran H, Pourakbari B, Mohebali M, et al. Clinical features and laboratory findings of visceral leishmaniasis in children referred to Children Medical Center Hospital, Tehran, Iran during 2004-2011. Iran J Parasitol. 2014;9(1):1–5.

Uzair M, Khan SJ, Munib S, Raheem F, Shah SH. Visceral leishmaniasis (Kala-azar): presentation, diagnosis and response to therapy. Gomal J Medical Sci. 2004;2:9-12.

Mansueto P, Seidita A, Vitale G. Transfusion transmitted leishmaniasis. what to do with blood donors from endemic areas? Travel Med Infect Dis. 2014;12 (6 Pt A):617–27.

Pereira CM, Oliveira HM, Lopes V. Visceral leishmaniasis after orthotopic liver transplantation: a rare cause of infection. Transpl Infect Dis. 2016;18:251–54.

Singh V, Singh M, Singh PS. Pancytopenia: etiologies and manifestation in eastern India. Int J Res Med Sci. 2017;5:5212-7.

Alvar J, Vélez ID, Bern C, Herrero M, Desjeux P, Cano J, et al. Leishmaniasis worldwide and global estimates of its incidence. PLoS One. 2012;7:e35671.

Rijal S, Chappuis F, Singh R, Bovier PA, Acharya P, Karki BM, et al. Treatment of visceral leishmaniasis in South-Eastern Nepal: Decreasing efficacy of sodium stibogluconate and need for a policy to limit further decline. Trans R Soc Trop Med Hyg. 2003;97:350–4.

Marsden PD, Nonata RR. Mucocutaneous leishmaniasis—a review of clinical aspects. Rev Soc Bras Med Trop1975;9:309–26.

Gupta V, Tripathi S, Tilak V. A study of clinico-haematological profiles of pancytopenia in children. Trop Doct. 2008;38:241Y243.

18. Jha A, Sayami G, Adhikari RC, et al. Bone marrow examination in cases of pancytopenia. JNMA. 2008;47:12Y17.

Pine M, Walter AW. Pancytopenia in hospitalized children: a five-year review. J Pediatr Hematol Oncol Jul. 2010;32:e192Ye194.

Minodier P, Piarroux R, Garnier JM, et al. Pediatric visceral leishmaniasis in southern France. Pediatr Infect Dis J. 1998;17:701Y704.

23. Pine M. A retrospective review of the etiologies of pancytopenia in hospitalized children without cancer. Pediatr Blood Cancer. 2009;52:689Y747.

24. Rey LC, Martins CV, Ribeiro HB, et al. American visceral leish maniasis (kala-azar) in hospitalized children from an endemic area. J Pediatr. 2005;81:73Y78.

Grant D. Clinical presentations of parvovirus B19 infection. Am Fam Physician. 2007;75:373Y376.

Dash S, Awasthi A, Marwaha RK. Hematological profile of childhood visceral leishmaniasis. Indian J Pathol Microbiol. 2005;48:4Y6

Agrawal Y, Sinha AK, Upadhyaya P, Kafle SU, Rijal S,.Khanal B, et al. Hematological profile in visceral leishmaniasis. Int J Infect Microbiol. 2013;2(2):39-44.

Singh V, Singh M, Singh PS. Pancytopenia: etiologies and manifestation in eastern India. Int J Res Med Sci. 2017;5:5212-7.

Gupta V, Tripathi S, Tilak V, Bhatia BD. A study of clinico-haematological profiles of pancytopenia in children. Trop Doct 2008;38:241-3.

Prieto Tato LM, et al. Visceral leishmaniasis: diagnosis and treatment. An Pediatr (Barc). 2010;72:347Y351.


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How to Cite
iqbal A, Qazi N- ul- ain, Gillani S, Hussain S, Raza MA, Ajmal J. INCIDENCE OF VISCERAL LEISHMANIASIS AMONG PANCYTOPENIC PAEDIATRIC PATIENTS. PJP [Internet]. 31Mar.2022 [cited 26Nov.2022];18(1):13-5. Available from: