Acute erythroid toxicity in visceral leishmaniasis: a rare complication of antimonial therapy.
The spectrum of side-effects of sodium stibogluconate is well described, however, little is known regarding the acute erythroid toxicity caused by this drug. We hereby present a case with this unusual complication of antimonial therapy. A 6-year-old male with leishmaniasis was started on parenteral sodium stibogluconate. During the course of treatment, his hemoglobin (Hb) dropped from 7.2 g/dl to 3.5 g/dl. Bone-marrow aspirate showed karyorrhexis in many erythroid precursors with several Leishmania donovanii bodies. Sodium stibogluconate was stopped and amphotericin-B was started. Four days after the cessation of the antimonials, the patient's Hb improved to 5 gm/dl with a corrected reticulocyte count of 10% indicating bone-marrow erythroid regeneration. The exact mechanism of this acute erythroid toxicity of sodium stibogluconate remains unexplored.
Sharma
Sunita
S
Department of Pathology, Lady Hardinge Medical College and Kalawati Saran Children Hospital, New-Delhi, India.
Malhan
Priya
P
Pujani
Mukta
M
Rath
B
B
D000818:Animals; D000967:Antimony Sodium Gluconate / Q000009:adverse effects*; D000981:Antiprotozoal Agents / Q000009:adverse effects*; D002648:Child; D041905:Erythroid Cells / Q000469:parasitology / Q000473:pathology*; D006801:Humans; D007893:Leishmania donovani / Q000302:isolation & purification; D007898:Leishmaniasis, Visceral / Q000188:drug therapy* / Q000469:parasitology; D008297:Male
D000981:Antiprotozoal Agents; D000967:Antimony Sodium Gluconate