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...

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Bibliographic Details
Main Authors: Sharma Sunita, Malhan Priya, Pujani Mukta, Rath B
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2008-10-01
Series:Indian Journal of Pathology and Microbiology
Subjects:
Online Access:http://www.ijpmonline.org/article.asp?issn=0377-4929;year=2008;volume=51;issue=4;spage=546;epage=547;aulast=Sharma
Description
Summary: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 <i>Leishmania donovanii</i> bodies. Sodium stibogluconate was stopped and amphotericin-B was started. Four days after the cessation of the antimonials, the patient&#x2032;s Hb improved to 5 gm/dl with a corrected reticulocyte count of 10&#x0025; indicating bone-marrow erythroid regeneration. The exact mechanism of this acute erythroid toxicity of sodium stibogluconate remains unexplored.
ISSN:0377-4929