Liver biopsy in the diagnosis of visceral leishmaniasis.
OBJECTIVE
To determine whether liver biopsy might be useful in the diagnosis of visceral leishmaniasis when bone marrow examination and serologic tests are inconclusive.


METHODS
Over a 10-year period, liver biopsy was performed in five children with suspected visceral leishmaniasis when indirect hemagglutination tests and bone marrow aspirations were not diagnostic.


RESULTS
Leishmania amastigotes were seen in Kupffer cells in all patients. The accompanying liver histopathological findings were ischemic necrosis in two children, macrovesicular steatosis in two children, portal inflammatory inflammation in two children, and piecemeal necrosis in one child. During the study period, 32 additional pediatric visceral leishmaniasis cases were diagnosed by bone marrow examination.


CONCLUSIONS
Liver biopsy can be recommended for diagnosing suspected visceral leishmaniasis in children when serology and bone marrow aspiration are inconclusive.
Artan
Reha
R
Department of Pediatric Gastroenterology, Hepatology and Nutrition, Akdeniz University School of Medicine, Antalya, Turkey. artan@akdeniz.edu.tr
Yilmaz
Aygen
A
Akçam
Mustafa
M
Aksoy
Nazif Hikmet
NH
D000293:Adolescent; D001706:Biopsy; D001853:Bone Marrow; D002648:Child; D002675:Child, Preschool; D005260:Female; D006386:Hemagglutination Tests; D006801:Humans; D007223:Infant; D007898:Leishmaniasis, Visceral / Q000175:diagnosis*; D008099:Liver / Q000469:parasitology* / Q000473:pathology; D008109:Liver Diseases, Parasitic / Q000175:diagnosis; D008297:Male