Kager P A, Rees P H
Trop Geogr Med. 1986 Dec;38(4):371-9.
Various haematological parameters were followed in a group of 47 Kenyan patients with visceral leishmaniasis during treatment and follow up. The WBC and platelet numbers were normal by the time of cure, the Hb level took longer to become normal. Red cells were microcytic and hypochromic. MCV and MCH increased during follow up but microcytosis persisted up to a year after cure. Low serum iron and transferrin concentration, low total iron binding capacity and normal to high serum ferritin levels were found in 10 patients and are consistent with 'anaemia of chronic inflammation'. Bone marrows of 15 patients before treatment were normo- to hypercellular with increased erythropoietic activity. Low haemosiderin content of the bone marrow was consistent with iron deficiency, but normalization of Hb without iron suppletion would argue against a major role of iron deficiency. Coagulation studies did not indicate diffuse intravascular coagulation. Splenomegaly seems the most important factor in the causation of the pancytopenia. Further studies of contributing factors and of the cause and mechanism of 'hypersplenism' are needed.
在治疗和随访期间，对47名患有内脏利什曼病的肯尼亚患者的各种血液学参数进行了跟踪。治愈时白细胞和血小板数量正常，血红蛋白水平恢复正常所需时间更长。红细胞呈小细胞低色素性。随访期间平均红细胞体积（MCV）和平均红细胞血红蛋白含量（MCH）增加，但小细胞症在治愈后长达一年仍持续存在。10名患者血清铁和转铁蛋白浓度低，总铁结合力低，血清铁蛋白水平正常至高，这与“慢性炎症性贫血”相符。15名患者治疗前骨髓细胞数量正常至高，造血活性增加。骨髓含铁血黄素含量低与缺铁相符，但在未补充铁的情况下血红蛋白恢复正常则表明缺铁并非主要因素。凝血研究未提示弥散性血管内凝血。脾肿大似乎是全血细胞减少症病因中最重要的因素。需要进一步研究相关因素以及“脾功能亢进”的病因和机制。
