Clinical findings and initial treatment response of patients with visceral Leishmaniasis admitted in Ali asghar children hospital from 1976 to 2010 in Tehran, Iran

Background: Visceral Leishmaniasis(VL) is a spreading potentially fatal zoonosis in Iran mimicking many other diseases in infancy which differs from VL in some other regions in terms of it’s clinical characteristics and response to therapy; earlier and better management is quite effective for life saving. Patients and Methods: All cases with final diagnosis of VL,2months to 12 years who were discharged from Ali Asghar children hospital from 1976 to 2010 were enrolled in this descriptive-analytic retrospective study; demographic,clinical, paraclinical parameters as well data concerning initial response to treatment were gathered and analyzed by appropriate statistical methods by SPSS software. Results: 58 patients with final diagnosis of Kala azar were admitted in Ali asghar children hospital from 1976 to 2010.36 cases(62%) were male; mean age of patients was 30 months(SD=24.98); Most cases had been admitted in spring (21cases,36%) and winter(18cases,31%),43% were living in Tehran and around Tehran.Fever was the most common symptom and observed in 54 cases(93.1%)followed by splenomegaly,hepatomegaly,pallor and cough. There was a significant association between fever onset until admission and presence of splenomegaly(P value=0.015), weight loss(P vaue=0.025)and pallor(0.029).Most cases(93%) had been treated by Glucantime; mostly with doses less than 20 mg/kg/day and there was no significant difference regarding initial response(stopping fever) between those who got final dosages less than or equal to 20mg/kg/day and those who received higher doses. Conclusion: Comparing to previous studies,there were some differences concerning presenting symptoms and signs on admission probably due to late diagnosis of VL in recently infected areas. Glucantime still has good effect for VL in Iran and it’s lower doses might also be effective for treatment although follow up studies are needed