Role of Haematological Changes in Predicting Occurrence of Leishmaniasis- A Study in Kumaon Region of UttarakhandCorrespondence Address :
Dr. Sanjay Singh Chufal,
Assistant Professor; Department of Pathology, Government Medical College, Haldwani, Uttarakhand-263139, India.
Introduction: A number of cases of Leishmaniasis have been reported from non-endemic sub-himalayan regions of India. Due to low clinical suspicion and atypical presentation, cases may go undetected or there may be a delay in diagnosis.
Aim: The aim of the study was to evaluate clinico-haematological parameters and bone marrow findings so that a high degree of suspicion could be made in unsuspected cases of Visceral Leishmaniasis (VL) and Leishman Donovan (LD) body negative bone marrow smears.
Materials and Methods: A retrospective study was conducted at a tertiary care centre serving the kumaon region of Uttarakhand from 2010 to 2014. Forty bone marrow aspirates were included, which were sent on clinical suspicion of VL. Twenty cases were positive for LD bodies. Their clinico-haematological features including bone marrow findings were studied in detail and compared with rest of the 20 LD negative cases. Five LD negative cases were also positive for rk39.
Results: Twenty LD positive cases were evaluated. Splenomegaly was the most common sign present in 17 cases (85%). Anaemia, leucopenia and lymphocytosis were present in all the cases (100%). Pancytopenia was seen in 17 cases (85%). Microcytic hypochromic blood picture was the most common finding in 11 cases (55%). Bone marrow was normocellular in 7 cases (35%), hypercellular in 7 cases (35%). Erythropoesis was micro-normoblastic in 11 cases (55%). Overall, there were 25 cases of VL (20 LD positive, 5 LD negative). Increased plasma cells, lymphocytes and histiocytes were seen in 17 cases (68%) of VL.
Conclusion: In non-endemic region where clinical suspicion is low, bone marrow findings can be a strong indicator for VL even though marrow is negative for LD bodies. If required other ancillary investigations can also be ordered. This study also emphasizes the need for epidemiological work up in this region.
Bone marrow, Haematology, Kalazar, Pancytopenia
Sanjay Singh Chufal, Prabhat Pant, Upasna Chachra, Paramjeet Singh, Naveen Thapliyal, Vinita Rawat. ROLE OF HAEMATOLOGICAL CHANGES IN PREDICTING OCCURRENCE OF LEISHMANIASIS- A STUDY IN KUMAON REGION OF UTTARAKHAND. Journal of Clinical and Diagnostic Research [serial online] 2016 May [cited: 2018 Jan 18 ]; 10:EC39-EC43. Available from
Date of Submission: Jun 30, 2015
Date of Peer Review: Nov 10, 2015
Date of Acceptance: Jan 27, 2016
Date of Publishing: May 01, 2016
Financial OR OTHER COMPETING INTERESTS: None.
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