Skip to main content
NCBI home page
Journal of Clinical Pathology logoLink to Journal of Clinical Pathology
. 1994 Jun;47(6):547–551. doi: 10.1136/jcp.47.6.547

Liver morphology and function in visceral leishmaniasis (Kala-azar).

I A el Hag 1, F A Hashim 1, I A el Toum 1, M Homeida 1, M el Kalifa 1, A M el Hassan 1
PMCID: PMC494751  PMID: 8063939

Abstract

AIM--To study the morphology and function of the liver in visceral leishmaniasis (Kala-azar). METHODS--Percutaneous liver biopsy specimens from 18 patients with confirmed visceral leishmaniasis were examined under light and electron microscopy before and after treatment with pentovalent antimony. The tissue was also examined for hepatitis B surface and core antigens using immunoperoxidase staining. Liver function was investigated in nine patients before and after treatment. RESULTS--Specimens before treatment showed Kupffer cells and macrophages colonised by leishmania parasites in 40% of cases. A chronic mononuclear cell infiltrate had affected the portal tracts and lobules. Ballooning degeneration of the hepatocytes, fibrosis of the terminal hepatic venules, and pericellular fibrosis were common findings. The fibrosis was related to Ito cells transforming to fibroblast-like cells. None of the patients had hepatitis B infection. All patients had biochemical evidence of liver dysfunction before treatment. Liver function improved after treatment. CONCLUSION--Visceral leishmaniasis causes morphological and functional disturbance in the liver. Focal fibrosis rather than cirrhosis occurs. The exact aetiology of hepatic damage is unclear but may have an immunological basis.

Full text

PDF
547

Images in this article

548Image
on p.548
548Image
on p.548
549Image
on p.549
549Image
on p.549
549Image
on p.549
549Image
on p.549

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Aggarwal P., Wali J. P., Chopra P. Liver in kala-azar. Indian J Gastroenterol. 1990 Apr;9(2):135–136. [PubMed] [Google Scholar]
  2. Carvalho E. M., Teixeira R. S., Johnson W. D., Jr Cell-mediated immunity in American visceral leishmaniasis: reversible immunosuppression during acute infection. Infect Immun. 1981 Aug;33(2):498–500. doi: 10.1128/iai.33.2.498-500.1981. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Clément B., Loréal O., Levavasseur F., Guillouzo A. New challenges in hepatic fibrosis. J Hepatol. 1993 Apr;18(1):1–4. doi: 10.1016/s0168-8278(05)80002-9. [DOI] [PubMed] [Google Scholar]
  4. Daneshbod K. Visceral leishmaniasis (kala-azar) in Iran: a pathologic and electron microscopic study. Am J Clin Pathol. 1972 Feb;57(2):156–166. doi: 10.1093/ajcp/57.2.156. [DOI] [PubMed] [Google Scholar]
  5. Duarte M. I., Corbett C. E. Histopathological patterns of the liver involvement in visceral leishmaniasis. Rev Inst Med Trop Sao Paulo. 1987 May-Jun;29(3):131–136. doi: 10.1590/s0036-46651987000300003. [DOI] [PubMed] [Google Scholar]
  6. French S. W., Miyamoto K., Wong K., Jui L., Briere L. Role of the Ito cell in liver parenchymal fibrosis in rats fed alcohol and a high fat-low protein diet. Am J Pathol. 1988 Jul;132(1):73–85. [PMC free article] [PubMed] [Google Scholar]
  7. Mak K. M., Leo M. A., Lieber C. S. Alcoholic liver injury in baboons: transformation of lipocytes to transitional cells. Gastroenterology. 1984 Jul;87(1):188–200. [PubMed] [Google Scholar]
  8. Minato Y., Hasumura Y., Takeuchi J. The role of fat-storing cells in Disse space fibrogenesis in alcoholic liver disease. Hepatology. 1983 Jul-Aug;3(4):559–566. doi: 10.1002/hep.1840030414. [DOI] [PubMed] [Google Scholar]
  9. Ogawa K., Suzuki J., Narasaki M., Mori M. Healing of focal injury in the rat liver. Am J Pathol. 1985 Apr;119(1):158–167. [PMC free article] [PubMed] [Google Scholar]
  10. Pampiglione S., Manson-Bahr P. E., Giungi F., Giunti G., Parenti A., Canestri Trotti G. Studies on Mediterranean leishmaniasis. 2. Asymptomatic cases of visceral leishmaniasis. Trans R Soc Trop Med Hyg. 1974;68(6):447–453. doi: 10.1016/0035-9203(74)90067-4. [DOI] [PubMed] [Google Scholar]
  11. Patrick M. K., Dunn I. J., Buret A., Miller H. R., Huntley J. F., Gibson S., Gall D. G. Mast cell protease release and mucosal ultrastructure during intestinal anaphylaxis in the rat. Gastroenterology. 1988 Jan;94(1):1–9. doi: 10.1016/0016-5085(88)90603-8. [DOI] [PubMed] [Google Scholar]
  12. Ridley D. S., Ridley M. J. Late-stage cutaneous leishmaniasis: immunopathology of tuberculoid lesions in skin and lymph nodes. Br J Exp Pathol. 1984 Jun;65(3):337–346. [PMC free article] [PubMed] [Google Scholar]
  13. Zijlstra E. E., Ali M. S., el-Hassan A. M., el-Toum I. A., Satti M., Ghalib H. W., Sondorp E., Winkler A. Kala-azar in displaced people from southern Sudan: epidemiological, clinical and therapeutic findings. Trans R Soc Trop Med Hyg. 1991 May-Jun;85(3):365–369. doi: 10.1016/0035-9203(91)90293-8. [DOI] [PubMed] [Google Scholar]
  14. el-Hassan A. M., Hashim F. A., Ali M. S., Ghalib H. W., Zijlstra E. E. Kala-azar in western Upper Nile province in the southern Sudan and its spread to a nomadic tribe from the north. Trans R Soc Trop Med Hyg. 1993 Jul-Aug;87(4):395–398. doi: 10.1016/0035-9203(93)90010-n. [DOI] [PubMed] [Google Scholar]

Articles from Journal of Clinical Pathology are provided here courtesy of BMJ Publishing Group

RESOURCES