Postmortem femoral bone marrow studies of Kala-azar

The Anaemia of Kala Azar

“…At that time the current view of causation of the anaemia was that 'it was in part due to haematopoietic depression, but in part to loss in epistaxis, dysentery, etc' (Cole, 1944). The view that 'crowding out of the erythrocyte precursors' resulted from the presence of the leishmaniae in the marrow was suggested by Chatterjee (1946) and, indeed, remained current until the present work was done. Chatterjee, who studied the marrow in fatal cases of kala azar, concluded that 'progressive cellular degeneration' explained the characteristic blood picture; in the femur in fatal cases he found the total number of cells to be diminished and almost all Knight et al(1967), however, found from studies of the ferrokinetics and life span of erythrocytes using radioisotopes that the marrow handled iron almost normally but that a major factor was marked shortening of the erythrocyte life span.…”

Pure Red Cell Aplasia in Kala Azar

“…The role played by several mech anisms in the causation of the anemia is complex and often unclear. An inhibition of red cell maturation by a depressant ac tion of parasite toxins on the marrow was initially reported [1,2]; however, an extracorpuscular hemolytic disorder with splenic sequestration is at present the most widely accepted mechanism of the anemia [3]. In pure red cell aplasia (PRCA), erythroblasts disappear from the marrow and reticulocytes from the blood, but granu lopoiesis and thrombopoiesis are relative ly unscathed.…”