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Sternal biopsy was made for and the dynamics of medullary hemopoiesis was examined in 20 patients with leptospirosis caused by L. icterohaemorragiae, L. canicola and L. gebdomadis. A severe icteric disease form complicated on day 10.75 +/- 1.26 by anemia was observed in all patients. A moderate activation of erythropoiesis, irritation of the lymphomonocytic sprout as well as oppression of the basophile and neutrophile series were the characteristic features of myelograms at the acute illness stage. Leptospirosis did not affect the functional ability of the bone marrow and no oppressive myelotoxic action as produced by Leptospira was observed. Anemia in patients with leptospirosis is predominantly of the hyperregenerative nature with the normoblastic hemopoiesis type.

The activity of glucose-6-phosphate dehydrogenase (G-6-PDG) of plasma and erythrocytes, levels of erythrocytes, hemoglobin, free hemoglobin and reticulocytes in different periods of illness were assessed in 30 men with severe icteric leptospirosis and anemia. Elevation of plasma G-6-PDG activity, levels of free hemoglobin (FH) and reticulocytes were found. Hemolysis was more pronounced at the height of the disease. One of the causes of hemolysis in severe leptospiral jaundice may be deficiency of erythrocytic G-6-PDG which is inheritable male disease. Low G-6-PDG activity of erythrocytes on the second week of the illness preceded anemia in 83.3% cases which could be a prognostic criterion of developing anemic syndrome. Combined treatment of leptospirosis with administration of tocopherol acetate resulted in a significant fall of plasma FH and G-6-PDG, of severity and duration of anemia versus the control group.

Blood samples from 46 patients with leptospirosis were analyzed on a Cobas Vega (ABX, France) device over the course of disease. Hemoglobin content, erythrocyte count, mean volume of erythrocytes, mean content and mean concentration of hemoglobin in an erythrocyte, anisocytosis index, reticulocyte count, and content of free hemoglobin (FH) were analyzed. Anemia (normocytic normochromic hyperregeneratory) is a typical manifestation of leptospirosis during the second week of disease. The leading pathogenetic mechanism of anemia associated with leptospirosis is erythrocyte hemolysis, whose intensity during the acute period depends on the severity of intoxication and extracorporeal methods of detoxication. Persistence of anemia during convalescent period is due to involvement of the kidneys (nephrotic nephritis).

Chromatin anisotropy is measured and its correlation with the cytochemical activity of leukocytes estimated in 19 patients with icterohemorrhagic leptospirosis. Leukocyte and neutrophil nuclei chromatin anisotropy increases during the acute period of leptospirosis, indicating an increase of cuchromatization and transcription activity. Neutrophil nuclei euchromatization is observed in patients with all forms of leptospirosis irrespective of the disease severity. Lymphocyte nuclei euchromatization is observed only in the patients with a favorable course but not in those with the severe course of the disease. Correlations between neutrophil and lymphocyte nuclei euchromatization and cytochemical activity of lymphocytes and monocytes are detected. The optic anisotropic effect is proposed to be used as an extra diagnostic criterion of leptospirosis severity.

The content of autorosettes in the peripheral blood forming from red cells round neutrophils and monocytes was found increased during the acute period of icterohemorrhagic leptospirosis. Autorosette-forming cells are characterized by a high activity of alkaline and acid phosphatases and low NBT-test values. The content of autorosettes directly correlates with the disease severity, bilirubin level, and presence of anemia. Assessment of autorosette-forming cells in patients with leptospirosis may be used as an additional test for evaluating the severity of intoxication, disease course, and for predicting the complications and disease outcome.