Hematological profile in visceral leishmaniasis

Abstract

INTRODUCTION: Visceral Leishmaniasis is the most severe form of leishmaniasis and can be fatal in the absence of treatment. Nepal, India, Bangladesh, Brazil and Sudan constitute five countries of the world where more than 90% of visceral leishmaniasis occurs. The aim of this study is to evaluate haematological profile with available clinical data in visceral leishmaniasis patients and to detect LD bodies among them. MATERIALS AND METHODS: It is a hospital based cross sectional study conducted in the Department of Pathology, BPKIHS, Dharan, for the period of one year. LD bodies were calculated in bone marrow aspirate of forty clinically suspected cases by counting the number of parasites per 100 consecutive oil immersion fields.RESULTS: The age ranged from 2-60 years. Pyerxia was the most common sign (100%) followed by splenomegaly (82.5%), hepatomegaly (65%), and pallor (75%). Anemia was present in 90%, leucopenia in 67.5% and thrombocytopenia in 72.5% cases. Bicytopenia and pancytopenia were observed in 40% and 25% cases, respectively. On peripheral examination RBCs were predominantly normocytic normochromic. On bone marrow examination normocellular marrow and megaloblastic features were predominant findings followed by increased plasma cells. Low, moderate and high grade LD bodies were present in 7.5%, 37.5% and 55% of the cases respectively. Hepatomegaly, anemia, neutropenia and lymphocytosis were statistically significant to parasite load (p-value <0.05).CONCLUSIONS: Besides LD bodies in bone marrow aspirates, dyserythroblastic changes and increase plasma cells are common findings in leishmaniasis. Patient from endemic area with positive clinical history and findings should be examined for LD bodies in marrow if dyserythroblastic and increase plasma cell picture is found

Haematological Abnormalities in &lt;i&gt;Visceral Leishmaniasis&lt;/i&gt; Patients Attending Gondar University Hospital; Retrospective Study

“…The hemoglobin count was ranged from 1.2 -18.5g/dl with mean 8.36 ± 2.55 g/dl and the prevalence of anemia was 94.4%which is similar with study done at Armed Forces Institute of Pathology, Rawalpindi Pakistan (94.3%) [21] and Nepal (90%) [23]. Prevalence of anemia in this study was lower than study done in Saudi Hospital, Hajjah Republic of Yemen (100%) [22] and in Dayanand Medical Collage and Hospital, Ludhiana (100%) [6].…”

“…It was found on 90.1% of the study population, which was higher than study done in Nepal (27.5%) [23]. This increases of neutropenia may be due to destroyed premature white blood cell (especially Neutrohpil) by parasite.…”

“…This severity may be due to destruction of erythrocytes and decrease production of red blood cells, because it was directly affected by parasite. Similarly prevalence of leucopenia was 95.4% with average leukocyte count of 1.87±1.17× 103/µl (ranged from 0.4 -8.3×10 3 /µl), which was higher than study done in Saudi Hospital Hajjah Republic of Yemen (81%) [22], Nepal (67.5%) [23], Dayanand Medical Collage and Hospital Ludhiana (83.3%) [6], Armed Forces Institute of Pathology Rawalpindi Pakistan (40%) [21]. This difference may be due to socio-demographic characteristics, and study population; in addition it may be due to delayed presentation to hospital which was attributing to hypersplenism since hypersplenism may cause leucopenia.…”

“…This increases of neutropenia may be due to destroyed premature white blood cell (especially Neutrohpil) by parasite. Prevalence of thrombocytopenia had 90.1% with platelet count ranged from 2-370×10 3 /µl with mean (79.68±57.6×10 3 g/µl) which were higher than study done in Armed Forces Institute of Pathology Rawalpindi Pakistan (15.7%) [21], Nepal (56%) [23], Saudi Hospital Hajjah Republic of Yemen (72.5%) [22] and in Dayanand Medical Collage and Hospital Ludhiana (73.3%) [6]. The difference may be due to socio-demographic characteristics, study population and study methods.…”

“…In the late stage of the disease, the eosinophilic myelocyes and mature Eosinohpil are greatly reduced. It has been observed that the decrease in leukocyte-erythrocyte ratio is directly proportional to the increasing size of spleen in Visceral Leishmaniasis [20,21,23,24]. …”