Cytomorphological Changes in Bone Marrow in Leprosy

Abstract

Background: This study was done to evaluate the cytomorphological changes and effectiveness of treatment on bone marrow involvement in leprosy. Subjects and Methods: Bone marrow aspiration was done in 126 cases (39 fresh and 87 on treatment) from sternum, smears were stained with leishmans stain and modified Ziehl-Neelsen stain to study the cytomorphological changes and presence of lepra bacilli. Maximum cases belonged to 4^th decade (31.74%). With male to female ratio of 4.7:1.Result: The bone marrow was normocellular in majority of cases (82.5 3%). The macrophage granuloma was found in (34.92%) of cases, while epithelioid granuloma was found in 31.74% cases. Out of 39 fresh cases acid fast-bacilli were demonstrated in bone marrow smears of 24 (62.53%) cases, while skin biopsies were positive in 28 (71.79%) cases. Of the 87 patients receiving treatment skin biopsies were positive only 16 (18.39%) cases whereas AFB persisted in bone marrow of 40 (45.97) cases. Conclusion: None of these cases of tuberculoid Leprosy should AFB in bone marrow as well as skin biopsy therefore study of bone marrow for AFB important in leprosy especially in multibacillary leprosy as with increasing duration of treatment although skin lesions became bacteriologically negative but AFB still persisted in bone marrow.