The splenic reaction in kala-azar

Abstract

A histopathological study of spleens from ten cases of human kala-azar has shown that the disease is a reticulo-endotheliosis caused by a parasitic invasion of the cytoplasmic reticular syncytium. There is a gradual differentiation of the reticulo-endothelial tissue to form free histiocytes which are also parasitized. The splenic reaction affords suggestive evidence for the presence in the spleen of two types of phagocytic cells with differing powers of phagocytosis. In the late stages of parasitization there is a spread of infection to the lymphatic reticulum of the spleen. Such an activation and invasion of the lymphatic reticulum is put forward as the explanation of the involvement of the lymphatic tissues in the disease. Reticulo-endothelial "blockage" is regarded as the probable cause of the anaemia and tendency to inflammatory complications.