ABSTRACT
Visceral leishmaniasis (VL) is a parasitic vector-borne disease endemic in Armenia. Its complications include hemophagocytic lymphohistiocytosis (HLH), which is a potentially fatal syndrome if misdiagnosed or left untreated. Higher clinical caution is required for the prompt diagnosis of HLH since the clinical findings associated with systemic inflammation overlap with those of many other pathological conditions, such as sepsis or Kawasaki disease. This study aims to provide an overview of the most common presentations that should prompt consideration of HLH. We described a case series of three pediatric patients with VL who developed HLH during antiparasitic treatment and received total doses of 40 mg/kg of liposomal amphotericin B for complete elimination of the pathogen.
ABSTRACT
PURPOSE: Central nervous system (CNS) tumors are the most common solid malignancies in children worldwide, including in Armenia. The current study aims to analyze epidemiological data, treatment, and outcomes of children and young adults (≤25 years) with CNS tumors in Armenia during the last 26 years. METHODS: We collected data from pediatric and young adult patients treated in selected sites in Armenia from 1st January 1995 to 31st December 2020. Incidence by sex, age at diagnosis, time from first complaints to diagnosis, histopathology results, treatment strategies, complications, and overall survival (OS) rates were calculated. RESULTS: The multicenter data analysis revealed 149 patients with diagnosed primary CNS tumors over 26 years. Among them, 84 (56.4%) were male. The median age at diagnosis was 7 years (range, 3 months to 25 years), and the median time from the first complaints to diagnosis was 2 months (range, 1 week to 70 months). Medulloblastomas and other embryonal tumors (47), low-grade gliomas (32), and high-grade gliomas (22) were the most commonly diagnosed malignancies. Ependymomas, craniopharyngiomas, germ cell tumors, and other malignancies were observed in 22 patients. For 26 patients, no histopathological or radiological diagnosis was available. Follow-up information was available for 98 (65.8%) patients. The 5-year OS rate for the whole study group was 67.7%. CONCLUSION: Consistent with international data, embryonal tumors, and gliomas were the most commonly diagnosed CNS malignancies in Armenia. Multimodal treatment was often not available in Armenia during the study period, especially for early cases.
