Hematological Profile of Newly Diagnosed Patients with Visceral Leishmaniasis from a Non-Endemic Hilly Region of India - Abstract
Aim: Visceral Leishmaniasis (VL) may lead to variable haematological responses like cytopenias, hemophagocytosis, dyserythropoiesis and increase in plasma cells. The purpose of this study was to investigate the hematological manifestation of VL and associated changes that may be observed in bone marrow aspirate smears.
Materials and methods: A 12-year hospital based cross section observational study was conducted in the Department of Medicine and Pathology in two tertiary care centres of Himachal Pradesh, located in the Northern India. In all 18 patients who were diagnosed as visceral leishmaniasis on the basis of demonstration of amastigotes, Leishman Donovan (LD) bodies in bone marrow aspiration smears were included in the study. Detail clinical history, examination and investigation were carried in each case as per protocol.
Results: Anemia was present in all the cases. Pancytopenia was observed in 61.1% of cases. Normocytic normochromic and dimorphic picture was the most common finding on peripheral smear. Bone marrow was normocellular in 83.3% of cases. Erythropoiesis was normoblastic in 33.3% of patients. Increased plasma cells, lymphocytes and histiocytes were seen in 50%, 33.3% and 22.2% of cases respectively.
Conclusion: In non-endemic region where clinical suspicion is low, bone marrow findings can be a strong indicator for VL and pathologist should look for LD bodies in the bone marrow to prevent the unnecessary delay in diagnosis.