title: High prevalence of functional liver derangement in visceral leishmaniasis at an Indian tertiary care center.
abstract: OBJECTIVE
  Functional derangement of liver in visceral leishmaniasis is reported infrequently in the literature. Because of this, many cases are wrongly diagnosed and treated as hepatitis. We therefore envisaged to assess the actual magnitude of liver function derangement in confirmed cases of visceral leishmaniasis at our hospital.
  
  
  METHODS
  All confirmed kala-azar cases presenting over a period of 3 years at our tertiary care hospital were included in the study. A detailed assessment of their liver functions was performed at the time of diagnosis and at various intervals until their discharge.
  
  
  RESULTS
  A total of 114 cases of microscopy-confirmed visceral leishmaniasis were included in the study. Of these, 15 (13%) had jaundice at the time of presentation, 58 (51%), 37 (32%), 27 (24%), and 24 (21%) had increased levels of aspartate aminotransferase, alanine aminotransferase, alkaline phosphatase, and bilirubin, respectively. Eleven of the 114 cases had a fatal outcome, of whom 9 (82%) had some form of functional hepatic derangement.
  
  
  CONCLUSIONS
  Thus, in our study, functional derangement of liver was found to be common in patients with visceral leishmaniasis. In some cases, hepatitis confounded and delayed the diagnosis of kala-azar.
authors.affiliation: Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India. purvamathur@yahoo.co.in
authors.forename: Purva
authors.initials: P
authors.lastname: Mathur
authors.forename: Jyotish Chandra
authors.initials: JC
authors.lastname: Samantaray
authors.forename: Palash
authors.initials: P
authors.lastname: Samanta
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000410:Alanine Transaminase / Q000097:blood; D000469:Alkaline Phosphatase / Q000097:blood; D001219:Aspartate Aminotransferases / Q000097:blood; D001663:Bilirubin / Q000097:blood; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007194:India / Q000453:epidemiology; D007223:Infant; D007565:Jaundice / Q000209:etiology; D007898:Leishmaniasis, Visceral / Q000150:complications* / Q000401:mortality; D008099:Liver / Q000473:pathology; D008107:Liver Diseases / Q000453:epidemiology* / Q000401:mortality / Q000469:parasitology*; D008111:Liver Function Tests; D008297:Male; D008875:Middle Aged; D015995:Prevalence
chemical_list: D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase; D000469:Alkaline Phosphatase; D001663:Bilirubin