Ultrastructure of white blood cells (WBC) were studied in peri pheral venous blood from Saudi patients with acute falciparum malaria (AFM) and compared with their counterparts in same patients 2 weeks after chloroquine treatment and full recovery. A counting system was incorporated to determine the rate of abnormal to normal cell type in plastic thick sections during the course of the disease. Neutrophilia, monocytosis, eosinopenia and lymphocytosis were associated with various ultrastructural abnor malities including: (1) Knobby phagocytic polymorphnuclear neu trophils (PMN) and promyelocytes, and PMN with highly vacuo lated cytoplasm. (2) Irregularly outlined electron-dense nuclei in non-functional monocytes. (3) Unusual distribution of nuclear chro matin in resting B-lymphocytes, while others possess highly vacuo lated cytoplasm and knobby surfaces. (4) Absence of granules in granular lymphocytes containing the known diagnostic paratubular crystalline arrays. (5) Plasmablasts containing electron-dense gra nules and swollen mitochondria. These abnormalities were sug gested to be due to the high level o f parasitaemia producing some toxic soluble products. They may also be attributed to alteration of bone marrow macrophages as a sequence of their interaction with soluble parasite products or their phagocytic parasitized red cells and debris released during the rupture of schizonts. This study showed that the number of abnormal WBC increases in patients with high level of parasitaemia; plasmablasts have the lowest rate o f abnormalities, while monocytes have the highest; old patients present with lower degree of parasitaemia than young patients due to a less mature immune system; and the AFM may have independent effects on the structure of human WBC.
Résumé : Paludisme à P. falciparum. IV-Altérations ultrastructurales des globules blancs périphériques.L 'ultrastructure des globules blancs est étudiée dans le sang vei neux périphérique chez des malades d 'Arabie Saoudite atteints de paludisme aigu à falciparum. Elle est comparée à celle des glo bules blancs chez les mêmes malades deux semaines après traite ment à la chloroquine et guérison totale.Des comptages ont été réalisés sur coupes semi-fines pour déter miner le pourcentage d'anomalies cellulaires pendant le cours de la maladie. Neutrophilie, monocytose, éosinopénie et lymphocy tose étaient associées à diverses anomalies ultrastructurales : 1) protubérances de l'enveloppe évoquant des knobs chez les promyélocytes, parfois associées à un cytoplasme très vacuolisé chez les polynucléaires neutrophiles ; 2) contour nucléaire irrégu lièrement dense chez les monocytes non fonctionnels ; 3) distribution anormale de la chromatine nucléaire dans certains lymphocytes B au repos, tandis que d 'autres ont un cytoplasme vacuolisé et une surface rugueuse ; 4) absence de granules chez les lymphocytes gra nuleux contenant les structures cristallines paratubulaires ; 5) granules denses et mitochondries gonflées dans les plasmoblastes.Cette étude montre que, le nombre de glo...