{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T15:14:40Z","timestamp":1781190880333,"version":"3.54.1"},"reference-count":34,"publisher":"The Pediatric Pharmacy Association","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:p>\n                    Liposomal amphotericin B is the first-line treatment for\n                    <jats:italic>Visceral leishmaniasis<\/jats:italic>\n                    ; however, drug hypersensitivity reactions, such as anaphylaxis, can pose significant challenges. Desensitization protocols are an option when alternative treatments are lacking. A 7-month-old female infant presented with persistent fever, pallor, splenomegaly, and laboratory findings suggestive of\n                    <jats:italic>Visceral leishmaniasis<\/jats:italic>\n                    with secondary hemophagocytic lymphohistiocytosis (HLH). After developing anaphylaxis following the first dose of liposomal amphotericin B (3 mg\/kg), a 14-step desensitization protocol was successfully implemented, allowing continuation of therapy without complications. After completing the course of treatment, the patient\u2019s fever resolved, spleen size normalized, and hematological parameters improved. Causality assessment using the Naranjo scale indicated a \u201cprobable\u201d adverse drug reaction (score = 6). This case represents the first reported successful use of a standard liposomal amphotericin B desensitization protocol in an infant under 1 year, demonstrating its feasibility and safety in managing anaphylaxis in endemic areas.\n                  <\/jats:p>","DOI":"10.5863\/jppt-25-00078","type":"journal-article","created":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T01:51:34Z","timestamp":1778550694000},"page":"432-436","source":"Crossref","is-referenced-by-count":0,"title":["First Infant Desensitization to Liposomal Amphotericin B"],"prefix":"10.5863","volume":"31","author":[{"given":"Maryam","family":"Rostamyan","sequence":"first","affiliation":[{"name":"Department of Infectious Diseases (MR), Hakim Children\u2019s Hospital, Tehran University of Medical Sciences, Tehran, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shirin","family":"Chinehkesh","sequence":"additional","affiliation":[{"name":"Department of Allergy and Immunology (SC), Hakim Children\u2019s Hospital, Tehran University of Medical Sciences, Tehran, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mahmoud","family":"Khodabandeh","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases (MK), Pediatrics Center of Excellence, Children\u2019s Medical Center, Tehran University of Medical Sciences, Tehran, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Farzad","family":"Kompani","sequence":"additional","affiliation":[{"name":"Department of Hematology and Oncology (FK), Pediatrics Center of Excellence, Children\u2019s Medical Center, Tehran University of Medical Sciences, Tehran, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"3883","reference":[{"issue":"12","key":"JPPT-25-00078-b01","series-title":"Clin Infect Dis","first-page":"e202","article-title":"Diagnosis and treatment of leishmaniasis: clinical practice guidelines by the Infectious Diseases Society of America (IDSA) and the American Society of Tropical Medicine and Hygiene (ASTMH)","volume":"63","author":"Aronson","year":"2016","unstructured":"Aronson N, Herwaldt BL, Libman M, et al. Diagnosis and treatment of leishmaniasis: clinical practice guidelines by the Infectious Diseases Society of America (IDSA) and the American Society of Tropical Medicine and Hygiene (ASTMH). Clin Infect Dis. 2016;63(12):e202\u2013e264."},{"issue":"5","key":"JPPT-25-00078-b02","series-title":"PLoS One","first-page":"e35671","article-title":"Leishmaniasis worldwide and global estimates of its incidence","volume":"7","author":"Alvar","year":"2012","unstructured":"Alvar J, V\u00e9lez ID, Bern C, et al. Leishmaniasis worldwide and global estimates of its incidence. PLoS One. 2012;7(5):e35671."},{"key":"JPPT-25-00078-b03","series-title":"World Health Organization","article-title":"Global leishmaniasis surveillance, 2021\u20132022: a baseline for the 2030 roadmap","year":"2023","unstructured":"World Health Organization. Global leishmaniasis surveillance, 2021\u20132022: a baseline for the 2030 roadmap. Geneva, Switzerland: World Health Organization; 2023. Accessed July 13, 2024. https:\/\/www.who.int\/publications\/i\/item\/9789240048294"},{"key":"JPPT-25-00078-b04","series-title":"Parasitol Int","first-page":"101934","article-title":"Treatment of resistant visceral leishmaniasis with interferon gamma in combination with liposomal amphotericin B and allopurinol","volume":"72","author":"Khodabandeh","year":"2019","unstructured":"Khodabandeh M, Rostami A, Borhani K, et al. Treatment of resistant visceral leishmaniasis with interferon gamma in combination with liposomal amphotericin B and allopurinol. Parasitol Int. 2019;72:101934."},{"issue":"10","key":"JPPT-25-00078-b05","series-title":"N Engl J Med","first-page":"764","article-title":"Liposomal amphotericin B for empirical therapy in patients with persistent fever and neutropenia","volume":"340","author":"Walsh","year":"1999","unstructured":"Walsh TJ, Finberg RW, Arndt C, et al; National Institute of Allergy and Infectious Diseases Mycoses Study Group. 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Efficacy and safety of liposomal amphotericin B for visceral leishmaniasis in children and adolescents at a tertiary care center in Bihar, India. Am J Trop Med Hyg. 2017;97(5):1498\u20131502."},{"issue":"4","key":"JPPT-25-00078-b08","series-title":"Trop Doct","first-page":"241","article-title":"Immediate hypersensitivity reaction following liposomal amphotericin-B (AmBisome) infusion","volume":"44","author":"Nath","year":"2014","unstructured":"Nath P, Basher A, Harada M, et al. Immediate hypersensitivity reaction following liposomal amphotericin-B (AmBisome) infusion. Trop Doct. 2014 Oct;44(4):241\u2013242."},{"issue":"3","key":"JPPT-25-00078-b09","series-title":"Allergy Asthma Proc","first-page":"201","article-title":"Successful rapid liposomal amphotericin B desensitization in pediatric case series","volume":"45","author":"Genis","year":"2024","unstructured":"Genis C, Sengul Emeksiz Z, Buyuk Yaytokgil S, et al. 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Allergy. 2022;77(2):357\u2013377."},{"key":"JPPT-25-00078-b12","series-title":"Front Pediatr","first-page":"1561600","article-title":"Hemophagocytic lymphohistiocytosis secondary to visceral leishmaniasis in children: case report and systematic review","volume":"13","author":"Chen","year":"2025","unstructured":"Chen Z, Gao Y, Zhang C, Mao J. Hemophagocytic lymphohistiocytosis secondary to visceral leishmaniasis in children: case report and systematic review. Front Pediatr. 2025;13:1561600."},{"issue":"12","key":"JPPT-25-00078-b13","series-title":"Pediatr Infect Dis J","first-page":"1311","article-title":"Hemophagocytic Syndrome in Children With Visceral Leishmaniasis","volume":"34","author":"Daher","year":"2015","unstructured":"Daher EF, Lima LL, Vieira AP, et al. Hemophagocytic Syndrome in Children With Visceral Leishmaniasis. 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Indian J Pharmacol. 2022;54(2):150\u2013152."},{"issue":"12","key":"JPPT-25-00078-b01","series-title":"Clin Infect Dis","first-page":"e202","article-title":"Diagnosis and treatment of leishmaniasis: clinical practice guidelines by the Infectious Diseases Society of America (IDSA) and the American Society of Tropical Medicine and Hygiene (ASTMH)","volume":"63","author":"Aronson","year":"2016","unstructured":"Aronson N, Herwaldt BL, Libman M, et al. Diagnosis and treatment of leishmaniasis: clinical practice guidelines by the Infectious Diseases Society of America (IDSA) and the American Society of Tropical Medicine and Hygiene (ASTMH). Clin Infect Dis. 2016;63(12):e202\u2013e264."},{"issue":"5","key":"JPPT-25-00078-b02","series-title":"PLoS One","first-page":"e35671","article-title":"Leishmaniasis worldwide and global estimates of its incidence","volume":"7","author":"Alvar","year":"2012","unstructured":"Alvar J, V\u00e9lez ID, Bern C, et al. 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