Diverse liver morphology in two cases of visceral leishmaniasis: Same face, different expressions

2021 ◽  
pp. 004947552110381
Author(s):  
Shashi Dhawan ◽  
Satyender S Dharamdesani
Keyword(s):  
Bone Marrow ◽  
Visceral Leishmaniasis ◽  
Bone Marrow Examination ◽  
The Other ◽  
Endemic Region ◽  
Travel History ◽  
Liver Morphology ◽  
Liver Biopsies

Two cases of visceral leishmaniasis are presented; one patient was from an endemic region and visceral leishmaniasis was suspected clinically, while the other was from a non-endemic region and it was not suspected clinically. Bone marrow examination was negative in both cases and both showed different morphological pictures in the liver biopsies. These are discussed. Importance of travel history is also highlighted even if it is in distant past.

BONE MARROW PROFILE IN HEMATOLOGICAL DISORDERS IN YEMENI PATIENS

2021 ◽  
pp. 61-65
Author(s):  
Saeed Thabet Nasher ◽  
Fayed Alyousufy ◽  
Khaled Alkubati ◽  
Sadam Al Halimy ◽  
Ramia Al Athwary
Keyword(s):  
Bone Marrow ◽  
Visceral Leishmaniasis ◽  
Lymphoblastic Leukemia ◽  
Bone Marrow Examination ◽  
Myeloproliferative Disorder ◽  
Lymphocytic Leukemia ◽  
Published Data ◽  
Hematological Disorders ◽  
Hematological Diseases ◽  
Age Related

There is paucity of information about the prevalence of hematological disorders in Yemen and neighboring countries .This is the rst project to evaluate the relative spectrum of hematological diseases in Taiz and Ibb governorate Yemen ,by method of bone marrow examination which is considered an important valuable diagnostic tool, for evaluation and nal diagnosis of various hematological and non-hematological disorders especially when CBC and peripheral blood lm study and other investigation failed to give a diagnosis . OBJECTIVES: The aim of this study was to evaluate the spectrum of haematological diseases diagnosed by bone marrow examination in Taiz and IBB governorates Yemen between September 2016 and October 2020 .Patients and method : A total of 1108 patients aged between (1 -100 )years old were evaluated by bone marrow examination at referral hematological center in IBB city Yemen . Relevant investigations were performed when needed. After exclusion of 98 patients with normal bone marrow ndings ,a total of 1010 patients had hematological disorders , and their data were analyzed. There were 527 (52.2 %) males and 483(47.8 %) females . A total of 655(64.9%) patients had benign hematological diseases and 355 (35.1% ) patients had malignant hematological diseases . RESULTS :A total of 138 patients had Iron deciency anemia ,107 had immune thrombocytopenic purpura (ITP) , 92 had hypersplenism,84 had Acute lymphoblastic leukemia ,79 had Acute myeloid leukaemia, 71 had megaloblastic anemia 58 had myeloproliferative disorder , 53 had Chronic myeloid leukemia , 45 had hemolytic anemia ,45had visceral leishmaniasis. 44 had malaria, 38 had chronic lymphocytic leukemia 38 had anemia of chronic disease ,25 had aplastic anemia ,25 had myelodysplastic syndromes, ,21 had anemia of infection ,19 had congenital syndroms,7had multiple myeloma ,6 had mixed deciency anemia and 5 had metastatic deposits , 4 had myeloid leukomoid reaction ,4 had lymphoma inltration and 2 had hairy cell leukemia . Sex- and age-related distribution of the various disorders was also presented. CONCLUSION: The anemias of all types were the most frequently encountered diagnosis followed by acute and chronic leukemias , ITP , Hypersplenism , ,myeloproliferative disorder , visceral leishmaniasis , malaria, myelodysplastic syndrome and congenital syndromes respectively. The other haematological disorders were less common. These ndings are comparable with published data in previous studies done in Yemen and other developing countries

scholarly journals TO DETERMINE THE FREQUENCY OF VISCERAL LEISHMANIASIS IN PERIPHERAL CYTOPENIC PATIENT IN PATHOLOGY DEPARTMENT HAYATABAD MEDICAL COMPLEX.

1969 ◽  
Vol 4 (2) ◽  
pp. 560-566
Author(s):  
ZARD ALI KHAN ◽  
MOHAMMAD SAJJAD ◽  
IMRAN UD DIN ◽  
MUKAMIL SHAH ◽  
SHAH JEHAN
Keyword(s):  
Bone Marrow ◽  
Visceral Leishmaniasis ◽  
Case Series ◽  
Bone Marrow Aspiration ◽  
Bone Marrow Examination ◽  
Total Leukocyte Count ◽  
Full Blood Count ◽  
Female Ratio ◽  
Pathology Department ◽  
Case Series Study

BACKGROUND: Visceral Leishmaniasis is a chronic disease and was first described in 1903, byLIESHMAN and DONOVAN. The disease is common in tropical and sub tropical areas of the worldwith various hematological manifestations. It is characterized by fever, visceromegaly, weight loss,pancytopenia and hypergammaglobulenemia. The disease is silent killer, invariably killing almost alluntreated patients, but curable with hematological improvement within 4-6 weeks of treatment.OBJECTIVE: To determine the frequency of Visceral Leishmaniasis in patints with cytopenias .MATERIAL AND METHODS: A descriptive study conducted in Pathology department, HayatabadMedical Complex, Hayatabad from September 1, 2012 to August 31, 2013. This study comprises of 126patients, subjected to complete blood counts. Diagnosis were confirmed by finding Amastigote( L/Dbody) from bonemarrow aspirate. All the patients who were referred to pathology Department of thehospital for bone marrow examination, with the results of peripheral blood using automatedHaematology analyzer, Sysmex KX 21 showing cytopenia were included in the study. Consent wastaken from the patient for bone-marrow aspiration procedure. After consent detailed history, physicalexamination was done.Laboratory investigations i.e. full blood count, which includes hemoglobin estimation, white blood cell,red blood, and platelet count.Bone marrow cytology (Giemsa stain) was recorded on the designed profroma.Posterior superior iliac spine (PSIS) was used as the site for aspiration in adults and children over 2years of ageRESULT: Descriptive case series study of 126 patients of peripheral cytopenia. In which 77 (61.1%)patients were males and 49 (38.9%) were female with male to female ratio of 1.57: 1 It was also foundin this study that visceral leishmaniasis was present in 29 (23%) of cases and the male: female were 1.6:1. Result of the automated hematology analyzer of peripheral cytopenic patients in visceralleishmaniasis show that all of the patients were having total leukocyte count less than 4000/cmm(100%). The hemoglobin level wass less than lOgm/dl in 26 cases (87.7%) and more than lOgm/dl inthree cases (10.3%). In case of platelets count, 27 cases (93.1%) were having platelets count less than150000/cmm.CONCLUSION: Incidence of visceral leishmaniasis is highier in children age group 1-10 years, alsomales are more prone than females. Leukopenia is recorded in all (100%) of the cases, followed bythrombocytopenia (93.1%) and anemia (Hb <10gm %) 87.7% cases.KEY WORD: Visceral Leishmaniasis, Kala Azar, Amastigote (L/D body)

scholarly journals Role of the Bone Marrow Examination among Undifferentiated Fever in Tropics

2018 ◽  
Vol 2 (2) ◽  
Keyword(s):  
Bone Marrow ◽  
Visceral Leishmaniasis ◽  
Bone Marrow Biopsy ◽  
Clinical Decision Making ◽  
Bone Marrow Aspiration ◽  
Clinical Decision ◽  
Bone Marrow Examination ◽  
Diagnostic Tools ◽  
P Value ◽  
Highly Sensitive

Background: Bone marrow aspiration and biopsy is one of the most important diagnostic tools for evaluation of undifferentiated fever. The positivity yield of these samples is highly specific that provides additional evidence for clinical decision making among the undifferentiated febrile cases. With this background we evaluated the bone marrow results of undifferentiated febrile cases for the last five years at B.P. Koirala Institute of Health Sciences, Dharan, Nepal. The objective of the study was to measure the sensitivity of the bone marrow investigations among undifferentiated febrile cohort. Methods: A retrospective study was performed from January 2010 till December 2014 evaluating bone marrow reports. Completed request forms and the histopathological reports of the bone marrow specimens were reviewed. Statistical data was analyzed using SPSS 17 and p-value of <0.05 was considered significant. Results: Over the half decade 319 specimens were collected for bone marrow biopsy out of that 27% were requested for undifferentiated fever. The mean and median age of the biopsy performed patients was 35 and 31 years respectively. Among all biopsy samples 59% was adequate for evaluation however among the undifferentiated febrile cases biopsy samples only 45% was adequate for evaluation. The sensitivity of bone marrow biopsy was 34%. There were 714 bone marrow aspiration samples of that 84% was adequate for evaluation. The most common etiological diagnosis for the undifferentiated fever from the marrow evaluation was visceral leishmaniasis (53%). The sensitivity of the bone marrow aspiration and aspiration or biopsy for visceral leishmaniasis was 95% and 98% respectively. (p value 0.03) Conclusion: Bone marrow aspiration is highly sensitive and specific for the diagnosis of visceral leishmaniasis among the undifferentiated fever at tropics in Nepal.

scholarly journals Hematological profile in visceral leishmaniasis

2013 ◽  
Vol 2 (2) ◽  
pp. 39-44 ◽  
Author(s):  
Y Agrawal ◽  
AK Sinha ◽  
P Upadhyaya ◽  
SU Kafle ◽  
S Rijal ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Visceral Leishmaniasis ◽  
Plasma Cells ◽  
Parasite Load ◽  
Clinical History ◽  
Bone Marrow Examination ◽  
Severe Form ◽  
P Value ◽  
Cross Sectional ◽  
Haematological Profile

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.  DOI: http://dx.doi.org/10.3126/ijim.v2i2.8320   Int J Infect Microbiol 2013;2(2):39-44

scholarly journals Efficacy of Combined Therapy with Liposome-Encapsulated Meglumine Antimoniate and Allopurinol in Treatment of Canine Visceral Leishmaniasis

2012 ◽  
Vol 56 (6) ◽  
pp. 2858-2867 ◽  
Author(s):  
Sydnei M. da Silva ◽  
Izabela F. G. Amorim ◽  
Raul R. Ribeiro ◽  
Erly G. Azevedo ◽  
Cynthia Demicheli ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Visceral Leishmaniasis ◽  
Drug Combination ◽  
Combined Therapy ◽  
Combined Treatment ◽  
Parasite Load ◽  
The Other ◽  
Sand Flies ◽  
Content Type ◽  
Meglumine Antimoniate

ABSTRACTAn innovative liposomal formulation of meglumine antimoniate (LMA) was recently reported to promote both long-term parasite suppression and reduction of infectivity to sand flies in dogs with visceral leishmaniasis. However, 5 months after treatment, parasites were still found in the bone marrow of all treated dogs. In order to improve treatment with LMA, the present study aimed to evaluate its efficacy in combination with allopurinol. Mongrel dogs naturally infected withLeishmania infantumwere treated with six doses of LMA (6.5 mg Sb/kg of body weight/dose) given at 4-day intervals, plus allopurinol (20 mg/kg/24 hper os) for 140 days. Comparison was made with groups treated with LMA, allopurinol, empty liposomes plus allopurinol, empty liposomes, and saline. Dogs remained without treatment from day 140 to 200 after the start of treatment. The drug combination promoted both clinical improvement of dogs and significant reduction in the parasitic load in bone marrow and spleen on days 140 and 200 compared to these parameters in the pretreatment period. This is in contrast with the other protocols, which did not result in significant reduction of the bone marrow parasite load on day 200. Strikingly, the combined treatment, in contrast to the other regimens, induced negative quantitative PCR (qPCR) results in the liver of 100% of the dogs. Both xenodiagnosis and skin parasite determination by qPCR indicated that the drug combination was effective in blocking the transmission of skin parasites to sand flies. Based on all of the parasitological tests performed on day 200, 50% of the animals that received the combined treatment were considered cured.

scholarly journals HEMATOLOGICAL CHARACTERISTICS OF YEMENI ADULTS AND CHILDREN WITH VISCERAL LEISHMANIASIS. COULD EOSINOPENIA BE A SUSPICION INDEX?

2017 ◽  
Vol 9 (1) ◽  
pp. 2017056 ◽  
Author(s):  
Jameel Al-Ghazaly ◽  
Waled Al-Dubai ◽  
Munasser Abdullah ◽  
Leila Al-Gharasi
Keyword(s):  
Bone Marrow ◽  
Visceral Leishmaniasis ◽  
Peripheral Blood ◽  
Bone Marrow Aspiration ◽  
Bone Marrow Examination ◽  
Control Group ◽  
Significant Difference ◽  
Adults And Children ◽  
Frequent Accompaniment ◽  
Suspicion Index

Background and objectives: Delay in the diagnosis of visceral leishmaniasis (VL) particularly in non-endemic areas is associated with higher mortality. In our experience, we found that marked bone marrow eosinopenia was a very frequent accompaniment of VL and might be a useful clue for the diagnosis, which indicates the opportunity for further morphological assessment. The aim of this study was to describe the hematological characteristics including peripheral blood and bone marrow findings of Yemeni adults and children with VL.Methods: We conducted a descriptive analytic study to evaluate systematically peripheral blood and bone marrow findings of Yemeni adults and children with VL. Peripheral blood and bone marrow aspiration of patients with bone marrow aspirate confirmed VL were examined. Forty-seven patients with the main age (±SD) of 17.34±11.37 years (Range: 1-60) were included in the study. Fifty-one non-VL subjects with splenomegaly and pancytopenia or bicytopenia served as control group.Results: All patients with VL had anemia, 41 (87%) leukopenia, 42 (89%) neutropenia, 44 (94%) thrombocytopenia, 42 (89%) eosinopenia, 34 (72%) pancytopenia and 13 (28%) had bicytopenia. In bone marrow examination 40 (85%) showed hypercellularity, 44 (94%) eosinopenia, 24 (51%) dyserythropoiesis, 22 (47%) lymphocytosis, 8 (17%) plasmacytosis, 27 (57%) decreased iron stores and 20 (43%) showed decreased sideroblasts. Comparison of VL patients with the control group showed significantly more frequent peripheral blood eosinopenia and lymphopenia and marrow eosinopenia. There was no significant difference between adults and children in any of the hematological features.Conclusion: Anemia, leukopenia, neutropenia, thrombocytopenia, eosinopenia, pancytopenia and marked bone marrow eosinopenia were the most common findings. The finding of marked bone marrow eosinopenia is a significant clue for the diagnosis of visceral leishmaniasis in patients who present with splenomegaly associated with cytopenias. This finding is particularly valuable in non-endemic areas.Keywords: Visceral Leishmaniasis, Yemen, Early Diagnosis, Hematological Features, Bone Marrow Eosinopenia.

scholarly journals VISCERAL LEISHMANIASIS;

2013 ◽  
Vol 20 (06) ◽  
pp. 884-890
Author(s):  
MUHAMMAD USMAN ◽  
FAYYAZ HUSSAIN ◽  
MUHAMMAD KASHIF BAIG
Keyword(s):  
Bone Marrow ◽  
Polymerase Chain Reaction ◽  
Visceral Leishmaniasis ◽  
Armed Forces ◽  
Bone Marrow Examination ◽  
Negative Control ◽  
Chain Reaction ◽  
Specific Test ◽  
Cross Sectional ◽  
Polymerase Chain

Leishmaniasis is a disease caused by protozoan parasite of genus Leishmania which is transmitted through bites ofinfected sand flies. It has been reported that Polymerase chain reaction (PCR) is more sensitive and specific test for the diagnosis ofvisceral leishmaniasis than bone marrow examination. This recent study is a renewed effort to validate the role of PCR in the diagnosis ofvisceral leishmaniasis. Objectives: The objective of this study was to determine the sensitivity and specificity of PCR in the diagnosis ofth visceral leishmaniasis. Duration of study: 25 March 2009 to 24th March 2010. Setting: Armed forces institute of pathology, Rawalpindi.Study design: Cross sectional (Validation) study. Materials and Methods: A total number of 59 patients of visceral leishmanaisisdiagnosed on bone marrow examination with equal number of negative controls were studied. The subjects were tested for the presenceof visceral leishmaniasis by polymerase chain reaction. Results: All the 59 patients were also found to be positive for visceralleishmaniasis by PCR. None of the negative control was positive on PCR. Conclusions: The study validates that PCR is equally sensitiveand specific test to bone marrow examination in the diagnosis of visceral leishmaniasis.

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