Bone marrow fibrosis (pseudo-myelofibrosis) in human kala-azar

Abstract

Thirty cases of human kala-azar were diagnosed by iliac crest biopsy and myeloculture. Histological analysis of 12 patients showed diffuse thickening of reticulin fibers. To the best of our knowledge, this is the third report describing secondary bone marrow fibrosis (myelofibrosis-like) associated with kala-azar. Patients with positive bone marrow fibrosis (pbmf = 12) were compared to patients without detectable bone marrow fibrosis (wbmf = 18). There were no significant differences in clinical and blood parameters following treatment. All patients showed regression of hepatosplenomegaly. Our findings suggest that associated bone marrow fibrosis is transient and did not interfere in the evolution of treated patients.

Bone marrow fibrosis: pathophysiology and clinical significance of increased bone marrow stromal fibres

“…Interestingly, increases in bone marrow reticulin staining have been observed in a variety of diseases that one might not expect to exhibit any type of bone marrow stromal changes. These include pulmonary hypertension (or its treatment with epoprostenol) (Popat et al , 2005, 2006); HIV infection (O'Malley et al , 2005); and the human parasitic disease, visceral leishmaniasis (Rocha Filho et al , 2000). In the case of HIV infection, one study of 35 patients found no correlation between the degree of bone marrow reticulin fibrosis and CD4 cell counts, suggesting that the mechanism of fibrosis in this condition is independent of the severity of HIV infection (O'Malley et al , 2005).…”

“…In the case of HIV infection, one study of 35 patients found no correlation between the degree of bone marrow reticulin fibrosis and CD4 cell counts, suggesting that the mechanism of fibrosis in this condition is independent of the severity of HIV infection (O'Malley et al , 2005). Similarly, in 12 cases of visceral leishmaniasis, increases in bone marrow reticulin appeared to have no significant influence on the progression of the disease, nor in the response to treatment (Rocha Filho et al , 2000).…”

Brucellosis presenting as myelofibrosis: First case report

“…Myelofibrosis can be seen in a variety of conditions, including chronic granulocytic leukemia, acute myeloid leukemia, multiple myeloma, and chronic lymphocytic leukemia. Infectious causes include kala-azar, 14 disseminated tuberculosis, histoplasmosis, 15 and Epstein-Barr virus. 16 Myelofibrosis can occur in cases of tuberculosis either due to hemophagocytosis, 8 or through the effect of transforming growth factor (TGF)-b which is produced from the tuberculosis granuloma and promotes fibrosis in the bone marrow.…”

Expressão do fator de crescimento insulina símile I (IGF-I) na patogenia da pancitopenia na leishmaniose visceral em hamster

“…Todos os procedimentos efetuados neste projeto foram autorizados pela Para complementar os dados da análise histopatológica, avaliamos nos animais infectados a ocorrência de deposição de ferro e aumento de fibras reticulares, alterações essas descritas em humanos com LV (Rocha-Filho et al, 2000;Yarali et al, 2002). Para tanto, realizamos colorações específicas em biopsia de medula óssea.…”