Acta Tropica 97 (2006) 252–258 Are there differences in clinical and laboratory parameters between children and adults with American visceral leishmaniasis? Arlene J.M. Caldas a,b,∗ , Jackson Costa a , Dorlene Aquino a,b , Antˆ onio Augusto M. Silva d , Manoel Barral-Netto a,c , Aldina Barral a,c a Centro de Pesquisas Gon¸ calo Moniz, Funda¸ c˜ ao Oswaldo Cruz (FIOCRUZ), Salvador, BA, Brazil b Departamento de Enfermagem, Universidade Federal do Maranh˜ ao, UFMA, S ˜ ao Lu´ ıs, MA, Brazil c Faculdade de Medicina da Bahia, Universidade Federal da Bahia, UFBA, Salvador, BA, Brazil d Departamento de Sa ´ ude P ´ ublica, Universidade Federal do Maranh˜ ao, UFMA, S ˜ ao Lu´ ıs, MA, Brazil Received 8 March 2005; received in revised form 30 August 2005; accepted 27 September 2005 Available online 18 January 2006 Abstract A prospective study on 23 patients with American visceral leishmaniasis (VL), comparing clinical and laboratory parameters of 14 children (mean age of 3.85 ± 3.39 years) to nine adults (27.4 ± 10.90 years) was performed in S˜ ao Lu´ ıs, Maranh˜ ao, Brazil, between August 2000 and July 2002. Data were collected at entrance (day 0), end of treatment, as well as 120 and 210 days after treatment using a protocol chart containing patient identification, clinical and laboratory data. N-Methylglucamine antimonate administered at the dose of 20 mg/Sb 5+ /kg/day for 20–30 days was successfully used in all patients. Patients were followed for 1 year after treatment, and no relapses were observed. A prolonged duration of the disease, lymphadenopathy and bleeding predominated in adult patients, while hepatomegaly and skin-mucosal pallor were more frequent in children. Disease was longer and more severe in adults than in children. Although both groups exhibited a trend toward normalization of hematological and biochemical parameters, more children returned sooner to normal values than adults. Difference in clinical or laboratory parameters between children and adults did not indicate the need for different clinical or therapeutic approaches. © 2005 Published by Elsevier B.V. Keywords: American visceral leishmaniasis; Children; Adults; Delayed-type hypersensitivity; Lymphoproliferative response Visceral leishmaniasis (VL) represents an important public health problem in the world. In the Americas it is commonly caused by Leishmania (Leishmania) chagasi, with Brazil accounting for more than 90% of the human cases occurring in the continent (OPAS, 1997; Brasil ∗ Corresponding author at: Laborat´ orio de Imunoparasitologia (LIP) do Centro de Pesquisas Gonc ¸alo Moniz-Fundac ¸˜ ao Oswaldo Cruz/FIOCRUZ-Bahia, Rua Valdemar Falc˜ ao, 121 (Brotas), Sal- vador/Bahia, CEP 40 295-001, Brazil. E-mail addresses: ajmc@elo.com.br (A.J.M. Caldas), jcosta@cpqgm.fiocruz.br (J. Costa). et al., 2004). In some Andean countries (Venezuela, Colombia, Ecuador, Peru and Bolivia) VL is rare. In Venezuela VL incidence was 0.2 cases per 100,000 inhabitants in 1998 (Davies et al., 2000). VL affects indi- viduals of different ages, but a predominance in adults has been observed in southeast Asian countries (Ashford et al., 1992). In Brazil, the disease preferentially affects children younger than 10 years and 75% of cases occur in those younger than 5 years (Ara´ ujo Sobrinho et al., 1999; Brasil et al., 2004). According to the Brazilian Min- istry of Health, from 1984 to 2002 there were 48,455 0001-706X/$ – see front matter © 2005 Published by Elsevier B.V. doi:10.1016/j.actatropica.2005.09.010