Indian Journal of Pathology and Microbiology
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Year : 2008  |  Volume : 51  |  Issue : 4  |  Page : 546-547

Acute erythroid toxicity in visceral leishmaniasis: A rare complication of antimonial therapy

1 Department of Pathology, Lady Hardinge Medical College and Kalawati Saran Children Hospital, New-Delhi, India
2 Department of Pediatrics, Lady Hardinge Medical College and Kalawati Saran Children Hospital, New-Delhi, India

Correspondence Address:
Mukta Pujani
Department of Pathology, Lady Hardinge Medical College and Smt. Sucheta Kriplani Hospital, New Delhi
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/0377-4929.43757

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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.

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