Hematologic Changes in Visceral Leishmaniasis/Kala Azar

Visceral Leishmaniasis (VL) or Kala Azar is a chronic infectious disease caused by parasites of the Leishmania donovani complex that can cause various hematologic manifestations. It is characterized by fever, enlargement of liver and spleen, weight loss, pancytopenia and hypergammaglobinemia. It is endemic in the Indian subcontinent, mainly seen in the states of Bihar and West Bengal. Patients with VL can present to the haematologist for various haematological problems prior to receiving the diagnosis of VL. Anaemia is the most common haematological manifestation of VL. VL may also be associated with leucopenia, thrombocytopenia, pancytopenia, hemophagocytosis and disseminated intravascular coagulation. Hematological improvement is noted within a week and complete hematological response occurs in 4–6 weeks of treatment. Relapses are rare and increased risk of being diagnosed with hematolymphoid malignancies on long term follow up is not noted.

[1]  P. Mathur,et al.  Fatal haemophagocytic syndrome and hepatitis associated with visceral leishmaniasis. , 2007, Indian Journal of Medical Microbiology.

[2]  H. Chung,et al.  Studies on the pancytopenia of kala-azar. , 1948, Blood.

[3]  S. Musumeci,et al.  Hematological and serological aspects of Mediterranean kala-azar in infancy and childhood. , 1980, Acta tropica.

[4]  D. Weatherall,et al.  Mechanism of anaemia in resistant visceral leishmaniasis. , 1986, Annals of tropical medicine and parasitology.

[5]  S. Sundar,et al.  Platelet function studies in Indian kala-azar. , 1995, The Journal of tropical medicine and hygiene.

[6]  J. B. Chatterjea,et al.  Haematological aspects of Indian kalaazar. , 1970, Journal of the Indian Medical Association.

[7]  M. Al-Nasser,et al.  The haematological manifestations of visceral leishmaniasis in infancy and childhood. , 1995, Journal of tropical pediatrics.

[8]  H. Murray Kala-azar--progress against a neglected disease. , 2002, The New England journal of medicine.

[9]  P. Kaye,et al.  Leishmania donovani infection of bone marrow stromal macrophages selectively enhances myelopoiesis, by a mechanism involving GM-CSF and TNF-alpha. , 2000, Blood.

[10]  I. Bates,et al.  Haematological Aspects of Tropical Diseases , 2010 .

[11]  V. Singh,et al.  Immune response to leishmania: paradox rather than paradigm. , 2007, FEMS immunology and medical microbiology.

[12]  Evaluation of direct agglutination test, rk39 Test, and ELISA for the diagnosis of visceral leishmaniasis. , 2008, The American journal of tropical medicine and hygiene.

[13]  A. W. Woodruff,et al.  The Anaemia of Kala Azar , 1972, Transactions of the Royal Society of Tropical Medicine and Hygiene.

[14]  R. Gupta,et al.  Clinico-hematological characteristics in patients with kala azar. A study from north-west India. , 1991, Tropical and geographical medicine.

[15]  P. Aso,et al.  Trypanosoma cruzi, Leishmania donovani, and L. mexicana: extract factor that lyses mammalian cells. , 1979, Experimental parasitology.

[16]  B. Bain,et al.  Chapter 4 – Preparation and staining methods for blood and bone marrow films , 2006 .

[17]  U. Dutta,et al.  Visceral leishmaniasis associated hemophagocytic lymphohistiocytosis--case report and systematic review. , 2008, The Journal of infection.

[18]  A. Elhassan,et al.  Leishmaniasis in Sudan. 3. Visceral leishmaniasis , 2001 .