THE HEMATOLOGICAL MANIFESTATIONS OF VISCERAL LEISHMANIASIS IN INFANCYAND CHILDHOOD

The haematological manifestations were reviewed in 94 patients (55 mal es and 39 females) with visceral leishmaniasis. Their ages ranged from 4 months to 12 years (mean per cent 1.8 years). All patients had sple nomegaly and were anaemic, while (73 per cent) were neutropenic and (5 6 per cent) thrombocytopenic. Coagulation abnormalities were encounter ed in 10 (11 per cent) patients; in four patients this was associated with disseminated intravascular coagulopathy. Bone marrow was hypercel lular in (90 per cent), normocellular in (5 per cent), and hypocellula r in (4 per cent). Also variable degrees of erythrophagocytosis and le ukophagocytosis were noted with preponderance of histiocytes (46 per c ent) and granulomatous formation (25 per cent). Low haemosiderin conte nt in the bone marrow was noted, which together with the finding of hi gh serum ferritin is consistent with anaemia of chronic inflammation. Hypersplenism, haemophagocytosis and granulomatous lesions of the bone marrow, chronic inflammation, and dietary factors appear to be the mo st important factors in the causation of the haematological changes in visceral leishmaniasis.