BONE-MARROW HISTOPATHOLOGICAL CHANGES IN VISCERAL LEISHMANIASIS

Over a period of two years (June 1989-May 1991), bone marrow trephine biopsies from 16 patients with visceral leishmaniasis were examined hi stologically to assess the correlation between the peripheral blood co unts and bone marrow status. Only 25% of patients had normal periphera l blood counts. Of the remainder, 25% had anemia alone, 25% had anemia with thrombocytopenia, and 25% had pancytopenia. The anemia was micro cytic/hypochromic in 88.7% of cases and normocytic in 12.3% of cases. Thrombocytopenia was a notable feature, with mean platelet count of 11 5 +/- 72.47 x 10(9)/L, and eight patients having thrombocytopenia belo w 120 x 10(9)/L. There was diffuse bone marrow hypercellularity in 13 cases and focal hypocellularity in three. The increased cellularity wa s attributable to trilineage hyperplasia, with a predominance of eryth roid activity in most cases. Increase in the histiocytic population wa s a prominent feature in all the cases. In 10 cases, most of the histi ocytes were found to be full of LD bodies, while in the other six, the parasite load was much less. Megakaryocytes were abundant in number, forming aggregates id most cases. Other notable features included eryt hrophagocytosis (nine cases) and moderate perivascular plasmacytosis ( 13 cases).