title: Liver morphology and function in visceral leishmaniasis (Kala-azar).
abstract: OBJECTIVE
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Pathology, Faculty of Medicine, University of Khartoum, Sudan.
authors.forename: I A
authors.initials: IA
authors.lastname: el Hag
authors.forename: F A
authors.initials: FA
authors.lastname: Hashim
authors.forename: I A
authors.initials: IA
authors.lastname: el Toum
authors.forename: M
authors.initials: M
authors.lastname: Homeida
authors.forename: M
authors.initials: M
authors.lastname: el Kalifa
authors.forename: A M
authors.initials: AM
authors.lastname: el Hassan
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D005355:Fibrosis; D006801:Humans; D007728:Kupffer Cells / Q000469:parasitology; D007898:Leishmaniasis, Visceral / Q000473:pathology* / Q000503:physiopathology; D008099:Liver / Q000473:pathology* / Q000503:physiopathology; D008109:Liver Diseases, Parasitic / Q000473:pathology* / Q000503:physiopathology; D008264:Macrophages / Q000469:parasitology; D008297:Male; D008875:Middle Aged; D013927:Thrombosis / Q000473:pathology