Profound thrombocytopenia in Plasmodium vivax malaria

Kakar, Atul; Bhoi, Sanjeev; Prakash, Ved; Kakar, Smita

doi:10.1016/s0732-8893(99)00069-3

Cited by 54 publications

(37 citation statements)

References 3 publications

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“…Pukrittayakamee et al [4] described a case of a volunteer experimentally infected with the Chesson's strain of P. vivax with a platelet count of 20x10 9 /L. Recently a case of vivax malaria associated with an initial platelet count of 5x10 9 /L was reported from India [5]. In our case, the patient presented with a severe thrombocytopenia of 8x10 9 /L, with spontaneous bleeding from the gums.…”

Section: Discussionmentioning

confidence: 47%

Plasmodium vivax malaria presenting with severe thrombocytopenia

et al. 2002

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Plasmodium falciparum and Plasmodium vivax malaria are endemic infections in India and are commonly associated with mild hematological abnormalities. Severe thrombocytopenia is common in isolated falciparum and mixed falciparum/vivax malaria, but is very rare in isolated P.vivax infection. We hereby report a case of severe thrombocytopenia (platelet count of 8x10 9 /L) in a case of vivax malaria. This is only the second case ever reported in the literature of such profound thrombocytopenia in a case of isolated P.vivax malaria. Key Words: Plasmodium vivax, malaria, severe thrombocytopenia. Malaria is common in most parts of India and is usually caused by P. falciparum and P. vivax. Though mild thrombocytopenia is common in both falciparum and vivax malaria, severe thrombocytopenia is reported especially in P. falciparum malaria and is very rare in isolated P. vivax infection. Both non-immunological as well as immunological destruction of platelets have been implicated in causing thrombocytopenia in such cases but the mechanisms involved are still not completely clear. Case ReportA 43-year-old male, resident of eastern India, arrived at the hospital emergency room with complaints of high grade, intermittent fever associated with chills and rigors during seven days. He also had a two-day history of mild spontaneous bleeding from the gums. There was no history of bleeding from any other site and no past or family history suggestive of bleeding diathesis. There was no history of any drug ingestion. On examination, the patient was febrile with a temperature of 40 o C. He had slight pallor and the liver and spleen were palpable 2 cm and 3 cm below the costal margin, respectively. There were no purpuric spots and the tourniquet test was negative.Routine blood investigations revealed 7.5 g/dL hemoglobin and a WBC count of 6.3x10 9 /L, with 54% neutrophils, 39% lymphocytes, 4% eosinophils and 3% monocytes. The platelet count was 8x10 9 /L. The peripheral blood smear showed numerous gametocytes of P. vivax in a background of marked thrombocytopenia. The 'OptiMAL® Rapid Malaria Dipstick Test' (DiaMed AG,Switzerland) for P. falciparum was negative but was positive for P. vivax. The bleeding time was prolonged to 9 minutes while the clotting time was 3 minutes, with a prothrombin time of 14 seconds (control 13 seconds) and activated partial thromboplastin time of 40 seconds (control 36 seconds). Glucose-6-phosphate dehydrogenase levels were normal and disseminated intravascular coagulation (DIC) was ruled out by normal levels of fibrinogen degradation products (FDP). Total serum bilirubin was 1.4 mg/dL with normal serum transaminase levels. Dengue serology (IgG and IgM) and Elisa for HIV were nonreactive. The patient was treated with antimalarials (quinine sulphate 10 mg/kg thrice daily) for 7 days and was given 6 units of platelet transfusions

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Section: Discussionmentioning

confidence: 47%

Plasmodium vivax malaria presenting with severe thrombocytopenia

et al. 2002

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“…Anju Aggarwal et al, 16 , Kakar A et al, 17 and Makkar RP et al, 18 from India had reported case of severe thrombocytopenia in patients suffering from Plasmodium vivax malaria.…”

Section: Resultsmentioning

confidence: 99%

Change in Hematological disturbances in Malaria in Eastern India: an observational study

Mukherjee

Chakrabarty

Sinharoy

et al. 2016

Bangladesh J Med Sci

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Abstract:Objectives: We wanted to find out the change and pattern of hematological disturbances in patients suffering from malaria and whether the hematological disturbances had any correlation with morbidity in them. Materials and methods: In a retrospective, observational study, first 100 admitted malaria patients in a tertiary medical institute in Kolkata, was taken from August 2009 to July 2011 and their demographic, clinical and laboratorial records were noted and analysed. Results: Seventy-one patients (71%) had anemia, ninety patients (90%) had thrombocytopenia, twenty-six patients (26%) had leucopenia and two patients (2%) had leukocytosis. Vivax malaria patients had lower platelet count than their falciparum counterparts, whereas falciparum malaria patients had lower hemoglobin, packed cell volume and higher total leukocyte count; all these hematological disturbances were found to be correlated with higher morbidity in patients suffering from malaria. Conclusion: In patients suffering from malaria, there was high incidence of hematological disturbances which was changing pattern and also correlated with morbidity.

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“…[6][7][8][9][10] Cases of malaria associated renal and hepatic impairment have been reported from different parts of malaria endemic countries. 11 Hepatic involvement in P. falciparum malaria Department of Pathology, Government Medical College, Aurangabad, Maharashtra, India is not an uncommon presentation and presence of jaundice (bilirubin >3mg/dl) is one of the indicators of severe malaria as defined by the WHO.…”

Section: Introductionmentioning

confidence: 99%

Study of haematological parameters in malaria

et al. 2017

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Background: Malaria causing plasmodia are parasites of blood and hence induce haematological alterations. The haematological changes that have been reported to accompany malaria include anemia, thrombocytopenia and leucocytosis, leukopenia, mild to moderate atypical lymphocytosis, monocytosis, eosinophilia and neutrophilia.Methods: Total hundred smear positive malaria cases were taken and various hematological parameters and biochemical parameters were studied.Results: Out of 100 smear positive cases, P. vivax was positive in 55 cases while P. falciparum was positive in 45 cases. It was seen in 86.67% of falciparum Malaria patients and in 72.72% of vivax Malaria patients. Severe anemia was seen in 9% of patients. Normocytic normochromic blood picture was the most common type in anaemic patients (51.89%). Thrombocytopenia was seen in 71% of the patients. Mild thrombocytopenia was more common and present in 52% of patients while Severe thrombocytopenia was seen in 19% of cases. In falciparum malaria thrombocytopenia was present in 66.66% of the patients while it was present in 74.54% of the patients in vivax malaria. Total Leucocyte Count was normal in 72% of the patients.Conclusions: Various haematological findings can help in early diagnosis of malaria which is essential for timely and appropriate treatment which can limit the morbidity and prevent further complications.

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Profound thrombocytopenia in Plasmodium vivax malaria

Cited by 54 publications

References 3 publications

Plasmodium vivax malaria presenting with severe thrombocytopenia

Plasmodium vivax malaria presenting with severe thrombocytopenia

Change in Hematological disturbances in Malaria in Eastern India: an observational study

Study of haematological parameters in malaria

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