| Summary: | De acordo com dado da OrganizaÃÃo Mundial de SaÃde (OMS) existem cerca de 12 milhÃes de pessoas no mundo com leishmaniose. No Brasil o agente etiolÃgico da Leishmaniose visceral (LV) à a Leishmania chagasi, e a principal forma de transmissÃo do parasita ao homem e outros hospedeiros mamÃferos à por meio da picada do mosquito fÃmea de insetos dÃpteros da famÃlia Psychodidae, cujo vetor principal à o Lutzomyia (Lutzomyia) longipalpis (Lutz & Neiva). O calazar ou leishmaniose visceral à uma doenÃa tropical que se caracteriza pela presenÃa de febre, anemia, hepatoesplenomegalia, manifestaÃÃes hemorrÃgicas, alÃm de linfoadenomegalia, perda de peso, taquicardia, tosse seca, diarrÃia, febre, pancitopenia e hipergamaglobulinemia. O envolvimento hematolÃgico à comum nos pacientes com LV, sendo a anemia a anormalidade mais freqÃente decorrente de natureza multifatorial e com prevalÃncia variÃvel conforme a populaÃÃo analisada. Consiste em avaliar o padrÃo das alteraÃÃes hematolÃgicas perifÃricas dos pacientes com Leishmaniose Visceral. As amostras de sangue foram colhidas apÃs o diagnÃstico laboratorial de pesquisa de formas amastigotas de Leishmania sp em aspirado medular nos pacientes (n=30) do Hospital SÃo Josà de DoenÃas Infecciosas, em Fortaleza, CearÃ, no perÃodo de Janeiro de 2007 a Julho de 2008 e de um grupo controle (n=30) constituÃdo de doadores de sangue do HEMOCE. As anÃlises laboratoriais foram realizadas no LaboratÃrio de AnÃlises ClÃnicas do Hospital Geral de Fortaleza e no LaboratÃrio Louis Pasteur Medicina DiagnÃstica. As contagens dos elementos sanguÃÃneos foram realizadas em contador hematolÃgico Pentra 120 ABX, seguido de avaliaÃÃo citomorfolÃgica. As dosagens bioquÃmicas foram realizadas em Analisador bioquÃmico HITACHI Modular P800 e Modulo E/RocheÂ. A comparaÃÃo entre os grupos, em relaÃÃo à mÃdia das variÃveis quantitativas foi realizada atravÃs do Teste t de Student, para os dados com hipÃtese de distribuiÃÃo normal e Mann-Whitney, no caso de nÃo normalidade dos dados. Foram considerados estatisticamente significantes valores de p < 0,05. Das anÃlises (n=30) pacientes, observou-se que 63%(19) dos pacientes sÃo do interior do Estado do Cearà e 37%(11) pacientes sÃo da capital, Fortaleza. Que 80%(24) dos pacientes sÃo do sexo masculino e 20(8%) do sexo feminino. A maioria dos pacientes, 57% apresentavam-se na faixa etÃria entre 31 a 45 anos de idade. Com relaÃÃo ao tempo da doenÃa atà a data do diagnÃstico laboratorial, 47%(14) dos pacientes jà apresentavam sinais clÃnicos da doenÃa com 30 a 90 dias. Obtivemos para o sexo masculino contagem das HemÃcias, uma mÃdia de 3,69 0,6644 (x106/mm3), Hemoglobina de 9,383Â1,3002 (g/dL), HematÃcrito de 28,6708Â4,0687(%),para o sexo feminino contagem das HemÃcias, uma mÃdia de 3,525 0,6233(x106/mm3), Hemoglobina de 8,5666Â1,6561(g/dL), HematÃcrito de 26,9666Â3,9026(%). Com relaÃÃo aos Ãndices hematimÃticros observamos para ambos os sexo, um Volume Corpuscular MÃdio(VCM) de 78,1Â7,0 (fL), Hemoglobina Corpuscular MÃdia(HCM) de 25,42Â2,51 (pg), ConcentraÃÃo de Hemoglobina Corpuscular MÃdia(CHCM) de 32 2,15 (%), DistribuiÃÃo de amplitude das hemÃcias(RDW) de 15,337Â2,435 (%), Contagem de reticulÃcitos de 20.636,63Â20.300,39 (/mm3). Das anÃlises citomorfolÃgica, Das anÃlises morfolÃgicas evidenciou-se um perfil laboratorial caracterÃstico de anemia do tipo microcÃtica e hipocrÃmica seguido de normocÃtica e normocrÃmica e em 65% das amostras observamos a presenÃa de ârouleauxâ. Para as determinaÃÃes do Ferro sÃrico obtivemos uma mÃdia de 32,53Â17,31 (Âg/dL), Transferrina de 146,83Â42,19 (mg/dL), Ferritina de 1339,47Â599,05 (ng/mL), Vitamina B12 de 573,5Â253,94 (pg/mL). Ãcido FÃlico de 10Â3,47 (ng/mL). Para as contagens dos leucÃcitos a mÃdia observada foi de 2802,33 Â2322,16 (nÂ/mm3), neutrÃfilos de 1.426,33Â1.348,88(nÂ/mm3), linfÃcitos de 982,60Â576,47x(nÂ/mm3), monÃcitos de 350,13Â283,47(nÂ/mm3), plaquetas de 120,233,33Â90.640,89 (nÂ/mm3). Para as determinaÃÃes do VHS ao diagnÃstico, os pacientes apresentaram uma mÃdia de 81,77 mm na primeira hora de observaÃÃo. As determinaÃÃes do TAP nos mostrou que ao diagnÃstico os pacientes apresentaram uma mÃdia de 67,87% de atividade de protrombina. Das anÃlises observou-se que na LV existe um comprometimento na hematopoese traduzindo no sangue perifÃrico por uma pancitopenia a favor principalmente da linhagem eritrÃide, sendo a anemia nestes pacientes de natureza provavelmente crÃnica === According to World Health Organization (WHO) data there are some 12 million people worldwide with leishmaniasis. In Brazil the etiological agent of visceral leishmaniasis (VL) is Leishmania chagasi, and is the main means of transmission from the parasite to human beings and other hosts mammals is through the biting of the female mosquito of the order diptera insects belonging to the Psychodidae family, whose main vector is the Lutzomyia (Lutzomyia) longipalpis (Lutz & Neiva). The visceral leishmaniasis or kala azar is a tropical disease that is characterized by the presence of fever, anemia, hepatosplenomegaly, hemorrhagic manifestations, and linfoadenomegaly, weight loss, tachycardia, dry cough, diarrhea, fever, pancytopenia and hypergammaglobulinemia. The hematological involvement is common in patients with VL, with anemia the most frequent abnormality due to its multifactor nature and prevalence varies depending on the population being studied. It is meant to evaluate the pattern of peripheral alterations of patients with hematological Visceral Leishmaniasis. Blood samples were collected after the diagnosis of researches seeking ways of amastigotes Leishmania sp in bone marrow aspirate in patients (n = 30), Hospital of Infectious Diseases SÃo JosÃ, in Fortaleza, in the state of CearÃ, in the period from January 2007 to July 2008 and a control group (n = 30) consists of blood donors from HEMOCE. Laboratory tests were performed at the Clinical Analysis Laboratory of the General Hospital of Fortaleza and the Louis Pasteur Medical Diagnosis Laboratory. The counting of blood elements were measured with an ABX blood Pentre 60 gauge, followed by cytomorphology assessment. The biochemical measurements were made in a HITACHI biochemical analyzer Module P800 and Roche  Modular I. The comparison between the groups, for the average of quantitative variables was performed by Student t-test, for the normal distribution and Mann â Whitney hypothesis data, in case of non-normality of the data. We have statistically considered meaningful values of 0.05. The analysis (n = 30) patients, the study showed that 63% (19) of the patients are from within the State of Cearà and 37% (11)of the patients are from the capital of the state of CearÃ, Fortaleza. That 80% (24) of patients are male and 20 (8%) were females. Most of the patients, 57% were aged between 31 to 45 years old. In what concerns the period of time of the disease until the date of laboratory diagnosis, 47% (14) of the patients already had signs of clinical disease with 30 to 90 days. We have to count the male of red blood cells, an average of 3.69  0.6644 (x106/mm3), hemoglobin of 9383  1.3002 (g/dL), Hematocrit of 28.6708  4.0687 (%) for the female count of red blood cells, an average of 3525  0.6233 (x106/mm3), hemoglobin from 8.5666  1.6561 (g/dL), Hematocrit of 26.9666  3.9026 (%) . With regard to RBC indices observed for both sex, cell volume Medium (MCV) of 78.1  7.0 (fL), mean corpuscular hemoglobin (MCH) of 25.42  2.51 (pg), mean corpuscular hemoglobin concentration (MCHC) of 32  2.15 (%), distribution of amplitude of red blood cells (RDW) of 15,337  2435 (%), reticulocyte count of 20.636.63  20.300.39 (/ mm3). Of the morphological analysis showed up a laboratory profile characteristic of the type of anemia and microcytic normocytic and hypochromic followed by normochromic and 65% of the samples found the presence of "rouleax". For the determinations of serum iron had a average of 32.53  17.31 (Âg/dL), Transferrin of 146.83  42.19 (mg/dL), Ferritin of 1.339.47  599.05 (ng /ml), Vitamin B12 from 573.5  253.94 (pg/mL), Folic Acid, 10  3.47 (ng/mL). For the average counts of leukocytes observed was 2802.33  2322.16 (nÂ/mm3), of neutrophils 1426.33  1348.88 (nÂ/mm3), lymphocytes from 982.60  576.47 (nÂ/ mm3); monocytes of 350.13  283.47 (nÂ/mm3), platelet count 120.233.33  90640.89 (n Â/mm3). For the determinations of the VHS diagnosis, the patients had an average of 81.77 mm in the first hours of observation. The determination of TAP showed us that the diagnosis of the patients showed an average of 67.87% of activity prothrombin. The analysis it was observed that there is an impairment in VL hematopoese in translating in peripheral blood by a pancytopenia mainly in favor of the erythroid lineage, and the anemia in patients with chronic nature probably
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