High prevalence of functional liver derangement in visceral leishmaniasis at an Indian tertiary care center.
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.
Mathur
Purva
P
Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India. purvamathur@yahoo.co.in
Samantaray
Jyotish Chandra
JC
Samanta
Palash
P
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
D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase; D000469:Alkaline Phosphatase; D001663:Bilirubin