Hematologic Changes in Visceral Leishmaniasis/Kala Azar

Visceral Leishmaniasis (VL) or Kala Azar is a chronic infectious disease caused by parasites of the Leishmania donovani complex that can cause various hematologic manifestations. It is characterized by fever, enlargement of liver and spleen, weight loss, pancytopenia and hypergammaglobinemia. It is endemic in the Indian subcontinent, mainly seen in the states of Bihar and West Bengal. Patients with VL can present to the haematologist for various haematological problems prior to receiving the diagnosis of VL. Anaemia is the most common haematological manifestation of VL. VL may also be associated with leucopenia, thrombocytopenia, pancytopenia, hemophagocytosis and disseminated intravascular coagulation. Hematological improvement is noted within a week and complete hematological response occurs in 4-6 weeks of treatment. Relapses are rare and increased risk of being diagnosed with hematolymphoid malignancies on long term follow up is not noted.