Acute erythroid toxicity in visceral leishmaniasis: a rare complication of antimonial therapy.
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2008-10-15
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Abstract
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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Sharma S, Malhan P, Pujani M, Rath B. Acute erythroid toxicity in visceral leishmaniasis: a rare complication of antimonial therapy. Indian Journal of Pathology & Microbiology. 2008 Oct-Dec; 51(4): 546-7