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Study of leukocyte profile in patients of fever with splenomegaly

Khushboo Garg, Anju Bharti, Sandip Kumar, Lalit Prashant Meena, Jaya Chakravarty, Madhukar Rai.


Background: There are many different possible etiologies of fever with splenomegaly; few patients with prolonged fever will remain undiagnosed despite an intensive diagnostic work-up. The presence of splenomegaly in patients with fever narrows down the differential diagnosis.

Objectives: The objectives of this study were as follows: (I) To evaluate the causes of fever with splenomegaly and (II) to study the leukocyte profile which includes pattern of total leukocyte count and differential leukocyte count (DLC) in various diseases presenting as fever with splenomegaly.

Materials and Methods: A total of 100 patients with fever and splenomegaly were included in the study. Complete hematological study such as complete blood count provided with main focus on total leukocyte count and DLC including neutrophil, basophil, eosinophil, lymphocyte, and monocyte and peripheral blood smear to especially note the morphology of white blood cells (WBCs) and to determine their relative percentage in blood.

Results: A total of 100 patients of fever with splenomegaly with male and female ratio of 1.7:1 were included in the study. While considering age-wise distribution, the highest percentage of cases was fell in the age group of 21–30 years. Infectious causes constituted 55% of cases, followed by hematological malignancies constituting 33% of cases. Other causes included 12% of cases. Kala-azar was the most common cause of fever with splenomegaly in our study followed by malaria and acute myeloid leukemia. Pancytopenia was found in 29% of cases and followed by 38% of bicytopenia cases in our study. About 32% of cases presented with normal total leukocyte count, 39% of cases showed leukopenia, and 29% of cases showed leukocytosis. Leukopenia was commonly found in kala-azar followed by hypersplenism. Neutropenia was most commonly present in kala-azar.

Conclusion: This study helps in understanding the distribution of leukocyte count and DLC pattern in various diseases presented as fever with splenomegaly and also the variable presenting signs and symptoms of these diseases so that the patients of fever with splenomegaly investigated and treated in a proper manner.

Key words: Leucocyte; Splenomegaly; Fever

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