RESUMO
In two infants with distal renal tubular acidosis phosphate depletion was observed in the extracellular and intracellular compartments of the erythrocytes. Treatment corrected this disturbance over a period of several months. Cell phosphate deficiency may contribute to the adverse effects of renal tubular acidosis on bone.
Assuntos
Acidose Tubular Renal/sangue , Eritrócitos/análise , Fosfatos/sangue , Trifosfato de Adenosina/sangue , Fosfatase Alcalina/sangue , Bicarbonatos/sangue , Cálcio/sangue , Humanos , Recém-NascidoRESUMO
A 3-year-old male child with high fever, hepatosplenomegaly, pancytopenia, haemolysis, striking histiocytosis and hemophagocytosis in bone marrow aspiration and high titre of cold agglutinin is described. Cold agglutinins were defined as polyclonal IgM with anti-I specificity. Diagnosis of visceral leishmaniasis was made on the basis of typical Leishman-Donovan bodies found in the patient's bone marrow, high titre of anti-leishmania antibodies and excellent response to treatment. Visceral leishmaniasis must be considered in the differential diagnosis of diseases with histiocytosis. Cold agglutinin syndrome may contribute to the haemolytic process which exists in leishmania-donovani infection.